Knowledge and attitudes toward depression among community members in rural Gujarat, India.

Limited data exist regarding community attitudes and knowledge about clinical depression in rural India. We administered 159 questionnaires and 7 focus groups to Gujarati villagers to explore knowledge and beliefs about clinical depression. Quantitative data were analyzed for frequencies, nonparametric correlations, and principal components, whereas qualitative data were coded for prominent themes. Two groups of subjects emerged from our analysis: one "medically oriented" group that viewed depression as a medical condition and expressed optimism regarding its prognosis and one "spiritually oriented" group that expressed pessimism. Correlations emerged between etiological belief, degree of optimism, and associated stigma. The subjects were pessimistic when they attributed depression to a traumatic event, punishment from God, or brain disease but optimistic when depression was attributed to socioeconomic circumstances. Overall, the subjects were knowledgeable and open-minded toward depression and demonstrated curiosity and willingness to learn more. This study will help to inform future clinical and educational outreach in rural Gujarat.

Magnetic nanoparticles and thermally responsive polymer for targeted hyperthermia and sustained anti-cancer drug delivery.

A novel cancer treatment method is being designed using a combination of iron oxide (Fe(3)O(4)) nanoparticles (IONPs) and Pluronic F-127 (PF127). IONPs have been used for heating tumors via an alternating electromagnetic (AEM) field. PF127 is a polymer possessing thermo-reversible and concentration-dependent gelation properties in aqueous solutions. PF127, as a gel, is an attractive drug delivery vehicle due to its zero-order drug release property. The combination of IONPs and PF127 would allow both short-term, tumor-specific, hyperthermic treatment, and long-term sustained drug delivery. As a preliminary study, the gelling and heating properties of IONPs/PF127 mixtures were investigated: 18% (w/w) PF127 was found to be ideal for our purpose because it gels at 28.0°C, i.e., it would be injectable at room temperature (20-25°C) and forms gel upon injection into the body (37°C). IONPs in PF127 showed little effect on gelation temperatures. The heating performance of IONPs in PF127 slightly, but linearly decreased with PF127. In the IONP concentration range of 0.01-0.05% (w/v) mixed with PF127 at 18% (w/w), the heating performance increased linearly with the increase in IONP concentration.

Case Report: Lactation Ketoacidosis Can Complicate the Ketogenic Diet.

INTRODUCTION: Ketoacidosis is a metabolic condition caused by the buildup of ketone bodies. The most common causes are diabetes, alcoholism, and starvation. This is a case of a lactating mother on a ketogenic diet who developed a community-acquired pneumonia and then went into life-threatening ketoacidosis. CASE PRESENTATION: A 32-year-old, lactating, 8-week-postpartum woman presented to the hospital complaining of nausea, vomiting, rhinorrhea, and cough. She had no history of diabetes or of alcohol or drug use but reported following a ketogenic diet and was found to have a pneumonia. The pneumonia was treated with antibiotics, and the acidosis resolved with a dextrose solution. CONCLUSION: We report the case of a mother who, while lactating and losing weight on a ketogenic diet, developed a pneumonia and then went into ketoacidosis. Physicians should be aware that patients on the ketogenic diet are at risk for life-threatening acidosis, especially if they develop a second and/or third stressor or energy requirement on top of the low-carbohydrate diet. This case and those reviewed in the literature indicate that ketogenic diets may not be safe during lactation and could be associated with increased morbidity.

A Case of Reversible Neuropsychiatry Symptoms in HIV due to Toxic Leukoencephalopathy.

Mothball ingestion has been previously cited to induce toxic-leukoencephalopathy, secondary to the destructive effects of paradichlorobenzene on central nervous system white matter. This case presents a 37-year-old woman who experienced a neuropsychiatric syndrome consistent with paradichlorobenzene-induced toxic leukoencephalopathy after two decades of mothball abuse. Her clinical presentation was insidious, involving fluctuating cognitive decline, depression, and psychosis. This was further complicated by an human immunodeficiency virus infection and concomitant cocaine abuse. Ultimately, her clinical findings were attributed to a reversible toxic-leukoencephalopathy from mothball ingestion, and her magnetic resonance imaging findings were consistent with symmetric leukoencephalopathy and atrophy. Though leukoencephalopathy in human immunodeficiency virus has numerous potential etiologies, a patient with a history of substance abuse warrants consideration of toxin-induced leukoencephalopathy, and further inquiry regarding abuse of other substances is appropriate.