Exploring the incidence and etiopathogenesis of pathological yawning as adverse side effect of psychotropic drugs.

INTRODUCTION: Yawning is a normal, stereotyped physiological event in humans and animal kingdom. When excessive (>3 per 15 minutes), it is termed as pathological yawning (PY). PY could be due to many causes but more commonly associated with side-effect of drugs, notably involving those used in psychopharmacology. Though there are isolated case reports and case-series, there are no large-scale reports of PY. This work attempted to address this lacuna. MATERIAL AND METHODS: The current work attempted to identify characteristics of PY as collated from adverse drug effect databases of Australia (Database of Adverse Event Notifications), Canada (Canada Vigilance Adverse Reaction Online Database) and the United States of America (FDA Adverse Event Reporting System - FAERS). These databases collect and provide public access to reports of adverse events related to drugs and therapeutic goods. They act as a prime pharmacovigilance tool as well as a first-line resource for healthcare professionals, researchers, and the public to monitor the safety of these products and make informed decisions. In the first week of June 2023, open access, unrestricted adverse effect of drug databases were explored, using the word "YAWNING" as the only search term for the side effect of any drug without any restrictions. The collected details of PY cases with their gender, age, reason for drug use, other concomitant complaints as well as the nature of adverse event(s) and its treatment requirements were assessed. Descriptive statistics were used. RESULT: Of the 2655 instances in USA database, 398(15%) had more than 1 suspect drug and in total 578 medications involved. The most commonly involved drugs were apomorphine, sertraline, fluoxetine and paroxetine. In all 341(12.8%) cases reported of YAWN alone or with one another sleep disorder, the most common off ending drug were fluoxetine hydrochloride. DISCUSSION AND CONCLUSION: The neural mechanism and physiology of yawning are explained. This study stresses that a health care professional, particularly mental health professionals and neurologists, should be aware of the importance of PY to deliver the best for the patients under their care. (Neuropsychopharmacol Hung 2023; 25(4): 194-205)

Decoding the link associated with areca nut chewing and cardiovascular disease using hsCRP as a biomarker.

Background: Chewing of areca nut is associated with various oral and systemic ill effects. The deleterious oral effects of areca nut have been widely documented to range from reactive lesions, periodontal health compromise to oral pre-cancer and cancerous states and have been described widely in the literature. The reported systemic effects of areca nut chewing are relatively less documented but reported in literature. Areca nut chewing may predispose to cardiovascular disease due to a systemic inflammatory response from the elevated levels of circulating inflammatory mediators. High-sensitivity C-reactive protein (hsCRP) is a systemic inflammatory biomarker to assess the risk of cardiovascular disease. Materials and Methods: This cross-sectional, observational study was conducted among areca nut chewers (n = 50) and non-chewers (n = 50). Areca nut chewers were considered as chewers/cases. Blood samples were collected from the participants and hsCRP levels were studied. The data were analysed using SPSS software, version 21 for statistical significance. Chi-square test was used to compare categorical variables. Mann-Whitney U test was done to analyse continuous variables. The level of statistical significance was set at P value < 0.05. Results: hsCRP mean was higher among the chewers (2.3 ± 3.7) compared to non-chewers (0.9 ± 1.3). The difference in hsCRP levels between the study group was statistically significant (P = 0.002). Conclusion: This study demonstrates the link between areca nut and cardiovascular disease using hsCRP as biomarker.

Evaluation of stress among dental undergraduates and postgraduates using salivary cortisol as a biomarker.

Background: Stress is a non-specific response of the body to any demand. Professional education has a certain level of stress inherent in it. Dental students have been reported in the literature to experience more stress than medical students. Objective: To evaluate the stress levels of dental students: first-year undergraduates, house surgeons, and final-year postgraduates, using salivary cortisol as a stress biomarker. Materials and Methods: Dental students above 18 years of age and without any systemic illness were included in the study. Those students with a drug history of corticosteroids, anti-depressants, and oral contraceptives were excluded from the study. Female participants experiencing pre-menstrual symptoms, pregnancy, and familial stressor issues were excluded from the study. First-year undergraduates, house surgeons, and final-year postgraduates were enrolled in the study. Unstimulated whole saliva was collected in the morning and evening between 9:00 and 10:00 am and between 3:00 and 4:00 pm. Salivary cortisol levels were assessed by chemiluminescence immuno-assay (CLIA). Results: Paired sample t-test was used to compare the diurnal variation among morning and afternoon samples within the groups. The salivary cortisol levels were found to be significant within the groups. One-way ANOVA was used to compare the salivary cortisol levels between the groups. The salivary cortisol levels within the groups were not statistically significant. Conclusion: Salivary cortisol is a non-invasive biomarker of stress. Postgraduates had higher salivary cortisol levels than other study groups.

Study of expression of endoglin (CD105) in oral squamous cell carcinoma.

Context: Oral cancer is the 8th most common cancer in the world. An important feature of carcinogenesis is angiogenesis. Endoglin is a powerful marker of neovascularization in solid malignancies. This study was done to ascertain its role as an indicator of metastasis and prognosis. Aim: This study aimed to evaluate and compare the expression of endoglin (CD105) in metastatic primary tumor, lymph node of the metastasized tumor, nonmetastatic primary tumor and in normal buccal mucosa immunohistochemically. Settings and Design: The total sample size comprised 45 formalin-fixed paraffin-embedded tissue blocks, n = 10 metastasized primary tumor, n = 10 lymph nodes of metastasized primary tumor, n = 20 nonmetastasized oral squamous cell carcinoma and n = 5 normal buccal mucosa were studied. Subjects and Methods: Immunohistochemistry for endoglin was performed and microvessel density (MVD) was determined by hot spot method. Microvessel density was compared between the groups. Statistical Analysis: Statistical analysis was used using one-way ANOVA. P < 0.05 was statistically significant. Results: Endoglin expression in metastatic cases (0.68 + 0.10) was higher than nonmetastatic cases (0.45 + 0.20) and the difference was statistically significant (P = 0.002). Conclusion: This study shows that presence of endoglin determines the metastatic potential of the tumor and its prognosis, thus, could be considered as a potential target of therapy.

Niveles de estrés de endodoncistas de la India durante la pandemia COVID-19 / Stress Levels of Indian Endodontists during COVID-19 Pandemic

RESUMEN Introducción: La COVID-19 se propaga por vías respiratorias y aerosoles. La pandemia originada por esta enfermedad causa pánico, miedo y estrés en todos los estratos de la sociedad. Al igual que todas las demás profesiones médicas, los dentistas, particularmente los endodoncistas, que están muy expuestos a los aerosoles, pueden mostrar estrés. Objetivo: Encuestar a los endodoncistas indios para comprender mejor sus niveles de estrés psicológico durante el confinamiento de la India durante la pandemia de la COVID-19. Métodos: Del 8 de abril al 16 de abril de 2020 se realizó una encuesta cerrada en las redes sociales de endodoncia. Se utilizó la técnica de muestreo de bola de nieve. Asimismo, se recolectaron datos demográficos básicos, entorno de práctica y otras informaciones relevantes. El estrés psicológico y la angustia percibida se calcularon a través del índice de angustia peritraumática COVID-19 y la escala de estrés percibido. El análisis de regresión multinomial se realizó para estimar la tasa de riesgo relativo y p ≤ 0,05 se consideró significativo. Resultados: Este estudio tuvo 586 endodoncistas indios que completaron esta encuesta. De estos, 311 (53,07 por ciento) eran hombres, 325 (55 por ciento) en el grupo de edad de 25-35 años, 64 por ciento en áreas urbanas, 13,14 por ciento en prácticas individuales y un cuarto de ellos eran residentes. Las mujeres endodoncistas tenían un alto estrés percibido (RRR = 2,46, p = 0,01) en comparación con los hombres, medido por PSS. Los endodoncistas más jóvenes < 25 años (RRR = 9,75; p = 0,002) y 25-35 años (RRR = 4.60; p = 0,004) en comparación con el grupo de edad > 45 años tenían más angustia. Los consultores exclusivos tuvieron RRR = 2,90, p = 0,02, para la angustia leve a moderada en comparación con la normal. Se consideran los factores que impulsan este fenómeno. Conclusiones: Durante el cierre debido a la COVID-19, los endodoncistas indios 1-en-2 tuvieron angustia, según lo medido por CPDI y 4 de cada 5 percibieron estrés, según lo indicado por PSS. Nuestro modelo identificó ciertos factores que impulsan el (des)estrés, lo que ayudaría a los formuladores de políticas a iniciar una respuesta adecuada(AU)

ABSTRACT Background: The novel 2019 COVID-19 spreads by respiratory and aerosols. COVID-19 driven pandemic causes panic, fear and stress among all strata of society. Like all other medical professions, dentists, particularly endodontists, who are highly exposed to aerosols would be exposed to stress. Objective: To survey the Indian endodontists to better understand their levels of psychological stress during the Indian lockdown COVID-19 Pandemic. Methods: From 8th April to 16th April 2020, we conducted an online survey in closed endodontic social media using snowball sampling technique, collecting basic demographic data, practice setting and relevant data. Psychological stress and perceived distress were collected through COVID-19 Peri-traumatic Distress Index and Perceived stress scale. Multinomial regression analysis was performed to estimate relative risk rate and p ≤ 0.05 was considered significant. Results: This study had 586 Indian endodontists completing this survey across India. Of these, 311(53.07 percent) were males, 325(55 percent) in the age group of 25-35 years, 64 percent in urban areas, 13.14 percent in solo-practice and a fourth of them were residents. Female endodontists had high perceived stress (RRR = 2.46, p = 0.01) as compared to males, as measured by PSS. Younger endodontists < 25 years (RRR = 9.75; p = 0.002) and 25-35years (RRR = 4.60; p = 0.004) as compared with > 45 years age-group had more distress. Exclusive consultants had RRR = 2.90, p = 0.02, for mild-to-moderate distress as compared to normal. Factors driving this phenomenon are considered. Conclusions: During the lock down due to COVID-19, 1-in-2 Indian endodontists had distress, as measured by CPDI and 4-in-5 of them had perceived stress, as indicated by PSS. Our model identified certain factors driving the (dis)stress, which would help policy framers to initiate appropriate response(AU)

Areca nut use disorder: A dynamic model map.

PROBLEM: Areca nut (AN) chewing is common among Southeast Asian population. Use of AN products (with or without tobacco) have a multifaceted effect on physical health, especially on cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. AN is a known group 1 carcinogen and carries addictive potential. Varying degrees of AN-related substance use disorder (SUD) have been reported among AN chewers. There is a lacuna in awareness of the health risk of AN use, prevention, and cessation programs among AN users, particularly in those who have developed SUD. EXISTING LACUNAE: The dynamic interaction of factors that promote AN use and later the risk of developing SUD at individual and community level has not been studied in depth. Understanding of the bio-psycho-socio-economic-cultural factors is necessary to identify the factors that prelude, promote, and reinforce AN usage. For managing AN-related conditions, including the several systemic disorders, there is a knowledge lacunae, among health care providers with respect to the pathophysiology of AN-related health issues, SUD, and nonavailability of structured, evidence-based cessation protocols. SOLUTIONS/RECOMMENDATIONS: This manuscript presents a model-map to study the dynamics of AN use and the impact of AN on health and health care system at individual as well as community level. The model proposed can help the health policymakers to create evidence-based awareness and cessation protocols for AN.

Evaluating and comparing the morphological and histopathological changes induced by erbium:yttrium-aluminum-garnet laser and diamond bur on enamel, dentin and pulp tissue.

AIM: Lasers are used for different types of dental treatments. Using the erbium:yttrium-aluminum-garnet (Er:YAG) laser to remove dental hard tissue is simple, advantageous and influences the type of cavity preparation, whether conventional or conservative in nature. The aim of the present study was to evaluate and compare the morphological and histopathological changes in the enamel, dentin and pulp tissue of the teeth treated by Er:YAG laser and conventional burs. METHODS: A conventional class I cavity was prepared in orthodontic patients by laser and bur. The teeth were extracted and analyzed for morphological changes using a scanning electron microscope, ground sections and histopathological changes under a light microscope. RESULTS: The time with laser was longer than the conventional methods. The lased cavity showed irregular appearance with absence of smear layer which is suitable for the resin restoration. The ground section and the histopathological study showed no differences between the groups. CONCLUSION: The Er:YAG laser is effective in the removal of dental hard tissue without damaging the pulp when coupled with ideal energy output. It is widely used in different dental fields. It needs time to be accepted by dentist and patients and further studies are required to explore its advantages.

The Indian dental litigation landscape: An analysis of judgments on dental negligence claims in Indian Consumer Redressal Forums.

INTRODUCTION: Dental malpractice/negligence litigations against dentists in India is not widely studied. The aim of this study is to report the Indian dentist related litigation landscape in consumer redressal forum (CRF) and to understand more of the nature of the same. MATERIAL AND METHOD: 111 cases of judgments of dental malpractice in Indian CRF were collected. Useful information was extracted, reported in a grid and statistically analyzed. Data was compared by claim, specialty, treatment offered, days lapsed and compensation awarded. P ≤ 0.05 was taken as statistically significant. RESULTS: In all, 44 (39.63%) dentists were found guilty. Thirty dentists had produced at least one evidence in their favor. Among them, 23 outcomes were in dentist's favor.(P = 0.02) The mean wait for final judgment was 1945 ±â€¯1286(193-6762) days. The mean compensation claimed was INR 577287 ±â€¯905898. Presence of evidence (dentists/patients) had an impact on the days to reach a judgment as well as compensation. CONCLUSION: Indian dental litigation landscape CRF has been described for the first time. We identified that CRF litigation of dental malpractice are few, as compared to number of procedures performed in India. Oral surgical procedures were often involved and 40% of instances, dentists were guilty and mean compensation awarded was INR 103998 ±â€¯158976.

Salivary Flow Alteration in Patients Undergoing Treatment for Schizophrenia: Disease-Drug-Target Gene/Protein Association Study for Side-effects.

BACKGROUND: Salivary flow alteration (SA), is a known unwarranted effect of schizophrenic medications. It manifest either as reduced (xerostomia) or increased (sialorrhea) SA, among treated schizophrenic patients. It is believed that the SA is due to action of the drugs/disease process involving the muscarinic receptor-3 to process acetyl choline, the common neurotransmitter. The genetic mediation behind the SA in such patients remains largely unexplored. We aimed to address the same by using curated literary databases to identify such relationship, if any existed. MATERIAL AND METHODS: Curated databases of Gene-Disease Association, www.DisGeNet.org and www.networkanalyst.ca were effectively used to identify the probable genes, strength of association and the drug-genes pathway that could be possibly be involved. The genes associated with schizophrenia and SA were analyzed in detail. Protein-Protein interaction (PPI) network proven experimentally in humans were used to identify the missing or unreported links. RESULTS: In all 28 genes associated with schizophrenia were linked to SA. The genetic network of schizophrenia and xerostomia involved FGFR2 gene prominently and network module was statistically significant (P = 9.87*10-8) was achieved that had xerostomia as a node, while schizophrenia (P = 0.025) had statistical significance. Sialorrhea had no statistical significance (P = 0.555). When schizophrenia and sialorrhea connections were analyzed for genetic interaction, only gene GCH1 emerged. On combining the three disease entities, the association of TAC1 gene with sialorrhea was also identified. Using PPI, the coordination of CHRM3, TAC1 and GPRASP1 gene were identified. This network involved several genes that has significant influence on calcium signaling pathway (P = 7.74*10-16), cholingeric synapse(P = 6 × 10-4), salivary secretion(P = 4.38*10-3), endocytosis(P = 8.23*10-4), TGFß signaling pathway(P = 0.0031), gap junction (P = 4.08*10-3) and glutamergic synapse(P = 6.4*10-3). The involvement of G-receptor signaling protein product, GNAQ was established. DISCUSSION AND CONCLUSION: The possible genetic pathway of SA in schizophrenic patients are discussed in light of pharmacotherapeutics. Using the knowledge effectively would help to increase the quality of life of schizophrenic besides increasing the understanding to use saliva as a biomarker of prognosis of schizophrenia and its drug effects.

Loricrin expression and its implication in oral submucous fibrosis, hyperkeratosis and normal mucosa with association to habits - An immunohistochemical study.

OBJECTIVE: The coarse fibres of areca nut and the continuous friction from occluding teeth are major causes of mechanical stress to the oral mucosa in conditions like oral submucous fibrosis and frictional keratosis. The continuous micro trauma provided in areca nut chewers, creates an environment where the keratinocytes exhibit alteration. Loricrin, is expressed abundantly in keratinizing epithelium in response to mechanical stress. Their expression or absence could play a role in malignant transformation. This study attempts to assess the potential of Loricrin as an early diagnostic marker in patients with chewing habit. METHODS: 73 archival samples of formalin fixed, paraffin embedded tissue specimens histopathologically confirmed, were segregated as normal mucosa 11, hyperkeratotic 32 and oral submucous fibrosis 30 and stained with antibodies to Loricrin and graded as negative, mild, moderate and intense based on the staining intensity. Pearson's chi square test was done for statistical analysis. RESULTS: Loricrin expression was observed in all groups with staining in the stratum granulosum showing a significant association to habits (P = 0.000). CONCLUSION: This prominent staining indicates a compensatory cytoskeletal rearrangement of surface epithelium during cell division in early oral submucous fibrosis showing potential as an early marker of the condition.

Risk of cognition alteration and emotional frailty via circulating transcriptome in treatment naïve head and neck squamous cell cancer patients.

BACKGROUND: There is a dearth of research examining the association between differential expression (DE) of genetic transcritome associated with cognition alteration (CA) and emotional frailty (EF) in treatment naïve head and neck squamous cell carcinoma (HNSCC) patients. The present study was undertaken to identify the DE of mRNA of CA-EF in HNSCC tumor and correlate with clinical and other known genetic factors that promote oncogenesis as well as CA-EF. MATERIAL AND METHODS: Using Genome-Wide Association Studies, putative genes associated with CA-EF(Prixie Fixie score ≥0.10) were identified. The DE of the mRNA of the thus selected genes were obtained from The CANCER GENOME ATLAS - HNSCC patients along with clinical details. The DE of mRNA pertaining to known factors such as inflammation, serotonergic and dopaminergic functions as well as clinical parameters were studied for association with the risk of DE of CA-EF. Appropriate statistics were performed and P ≤ 0.05 was taken as significant. RESULTS: A total of 520 HNSCC patients formed study group. There were 77 (14.81%) patients at risk for CD, 41 (7.9%) for CI and 113 (21.73%) for EF risk. In all, 103 (19.81%) HNSCC patients of this cohort had DE of mRNA of genes associated with CA. Inflammation, circadian genes, mTOR pathway, invasion and metastasis set of genes had a significant association with the risk of DE of CA-EF. DISCUSSION: Transcriptome's have been postulated to mediate CA-EF by targeted action on human brain. Differential Expression of putative genes associated with CA-EF have been demonstrated in HNSCC tumor. These DE could predispose the patients to CA-EF by the action of gene-environmental as well as psycho-social constructs. As CA-EF could adversely influence the treatment and alter the quality of life among survivors, screening for CA-EF at HNSCC presentation becomes imperative.

Nasolabial cyst in buccal mucosa.

Nasolabial cysts are a rare non-odontogenic, soft-tissue, developmental cyst reported till date in the sublabial area and anterior maxillary region. The cyst is a slowly enlarging asymptomatic swelling and non-painful. The cyst is believed to be associated with remnants of the nasolabial duct. In this report, we report a nasolabial cyst of a 48-year-old man in whom the cyst occurred in the buccal mucosa. To the best of our knowledge, this is the first case of nasolabial cyst occurring entirely in the buccal mucosa without involving vestibule. The etiopathogenesis of the cyst is reviewed in light of this case.

"Burden of the Triumph:" Burden of peri-implantitis in Indian population - A mathematical model.

CONTEXT: India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI. MATERIALS AND METHODS: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated. RESULTS: Based on assumptions, 909,643 Indians, (830,231-858,703) would choose DI. Estimated number of peri-implantitis would be 145,543-254,700 and estimated number of failures should be 50,940-79,412 in the near future. CONCLUSIONS: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.

A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness.

OBJECTIVE: Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient's awareness of AIM. The knowledge would help dentists to deliver oral care for schizophrenics with TD. MATERIALS AND METHODS: We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with P≤0.05 as significance. RESULTS: The mean of only orofacial features (n = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient's perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (P≤0.05). The multiple regression model statistically significantly predicted TD for factors considered. CONCLUSION: Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management.

Influence of legislations and news on Indian internet search query patterns of e-cigarettes.

BACKGROUND: There is a paucity of data on the use of electronic nicotine delivery systems (ENDS) in India. In addition, the Indian internet search pattern for ENDS has not been studied. We aimed to address this lacuna. Moreover, the influence of the tobacco legislations and news pieces on such search volume is not known. Given the fact that ENDS could cause oral lesions, these data are pertinent to dentists. METHODS: Using a time series analysis, we examined the effect of tobacco-related legislations and news pieces on total search volume (TSV) from September 1, 2012, to August 31, 2016. TSV data were seasonally adjusted and analyzed using time series modeling. The TSV clocked during the month of legislations and news pieces were analyzed for their influence on search pattern of ENDS. RESULTS: The overall mean ± standard deviation (range) TSV was 22273.75 ± 6784.01 (12310-40510) during the study with seasonal variations. Individually, the best model for TSV-legislation and news pieces was autoregressive integrated moving average model, and when influence of legislations and news events were combined, it was the Winter's additive model. In the legislation alone model, the pre-event, event and post-event month TSV was not a better indicator of the effect, barring for post-event month of 2nd legislation, which involved pictorial warnings on packages in the study period. Similarly, a news piece on Pan-India ban on ENDS influenced the model in the news piece model. When combined, no "events" emerged significant. CONCLUSIONS: These findings suggest that search for information on ENDS is increasing and that these tobacco control policies and news items, targeting tobacco usage reduction, have only a short-term effect on the rate of searching for information on ENDS.

An Audit of Indian Health Insurance Claims for Mental Illness from Pooled Insurance Information Bureau's Macroindicator Data.

INTRODUCTION: Information on the social and voluntary insurance coverage of mental illness in India is scarce. We attempted to address this lacuna, utilizing a secondary macrodata approach for 3 years. Mental illness per se is not covered by most of existing Indian health insurance policies. MATERIALS AND METHODS: Publicly available de-identified claim macrodata for all health (nonlife) insurance for Indian financial year from 2011-2012 to 2013-2014 were collected. The age group, gender, amount of claims, proportion of claims, and details of number of days of hospitalization were collected and analyzed. Descriptive statistics, Chi-square test, and Wilcoxon tests were used appropriately. P ≤ 0.05 was considered statistically significant. RESULTS: In 2011-2012, there were 2864 claims from the registered 2,591,781 members citing mental illness (0.11%) which decreased to 0.03% in 2012-2013 and marginally rose to 0.07% of all claims. The total amount of claims paid for mental illness was Rs. 51.7 millions in 2011-2012, Rs. 97.2 million in 2012-2013, and Rs. 150 million in 2013-2014. Statistically significant difference emerged in terms of age group, gender, amount and proportion of claim, and number of days of hospitalization. CONCLUSION: The penetration of health insurance is low and claim for mental illness remains low. The difference in patterns of age, gender, amount of claims, and number of days for mental illness provides detailed relevant information to formulate future policies.