Hemolacria is a rare manifestation of dissociative disorder. Aim of index report was to present clinical findings in a 13-year old female and explore the socio-cultural meaning associated with this phenomenon. Eclectic psychotherapeutic approach was implemented to address the symptoms. To conclude, physical symptoms presenting in dissociative disorder may be conceptualized in socio-cultural context.

Aim: This study aims to evaluate the prevalence of psychiatric morbidity and suicidal behavior by using a structured diagnostic interview in patients of chronic kidney disease currently on dialysis. An additional aim of the study was to evaluate the impact of psychiatric morbidity on quality of life (QOL). Methodology: One hundred and ten patients undergoing hemodialysis were evaluated, at least 24 h after the last dialysis on Mini International Neuropsychiatric Interview PLUS (MINI PLUS), Columbia Suicide Severity Rating Scale (C-SSRS), and Beck Depression Inventory Second Edition. Results: On MINI-PLUS, about two-thirds (67.3%) of the study sample fulfilled at least one-lifetime psychiatric diagnosis and half of the study participants fulfilled a current psychiatric diagnosis. More than one-fourth (29.1%) of the study participants had more than one psychiatric diagnosis. Among various psychiatric disorders, depressive disorders were the most common (45.5%). About one-third of the participants had suicidality, as assessed on MINI-PLUS and C-SSRS. Compared to those without psychiatric morbidity, those with psychiatric morbidity had a poor QOL. Conclusions: In view of the high psychiatric morbidity and its negative impact on the QOL of patients undergoing hemodialysis, there is a need for close liaison between nephrologists, transplant surgeons and mental health professionals.

Aim: The primary objective of the study was to evaluate the extent of stigma for mental disorders among the older adults (aged ≥60 years) from a rural background visiting a general outpatient's clinic at the civil hospital as an attendant of patients. The secondary objective of the study was to assess the correlation of stigma with the sociodemographic profile and family history of mental illness. Methodology: One hundred and four older adults (aged ≥60 years) from a rural background visiting a general outpatient's clinic at the civil hospital as an attendant of patients with physical illnesses were evaluated on Community Attitudes toward the Mentally Ill (CAMI) Scale. Results: About three-fifths of the participants (59.6%) were females. About one-third (32.7%) of the study participants had a family history of mental illness. On CAMI Scale, the highest score was obtained in the domain of benevolence (BE), followed by authoritarian, community mental health ideology (CMHI), and social restrictiveness (SR). Those with a family history of mental illness and from middle socioeconomic status scored significantly higher on the SR domain of CAMI. Level of education had a significant positive correlation with the scores in the domains of BE, SR, and CMHI. Age had a significant negative correlation with the SR domain score. Conclusions: Elderly in a rural setting, in general, have a positive attitude toward mental illness and have a lower level of stigma associated with mental illnesses. Certain demographic and clinical variables such as middle socioeconomic status, low level of education, and presence of mental illness are associated with stigma.

BACKGROUND:Little is known from India about the experience of using olanzapine long-acting antipsychotic injectables (LAI). In this background, this study aimed to evaluate the clinical profile of patients suffering from schizophrenia who were prescribed olanzapine LAI and to evaluate the usefulness and acceptability of olanzapine LAI among these patients.METHODS:In this retrospective study, data of all the patients with schizophrenia receiving olanzapine pamoate, was extracted.RESULTS:40 patients (males-55%; mean [SD] age- 36.2 (12) years; mean duration of illness (SD) prior to depot-143.3 (115.9) months) were included in the study. Olanzapine LAI was invariably prescribed in patients with a past history of non-compliance. Data was available for a mean (SD) follow-up duration of 17 (10.8) months. The most frequently used dose of olanzapine LAI used was 300 mg every two weeks (55%). This was followed by 405 mg every four weeks in (32.5%). Mean Clinical Global Impression (CGI) Severity score prior to starting of olanzapine LAI was 5.8 (0.7), which reduced to 2.7 (1.1) at the time of last follow-up or the last use of olanzapine LAI, and this was a statistically significant improvement (paired t-test value = 16.41; P < 0.001). Only one (2.5%) patient experienced Post injection Delirium/Sedation Syndrome during the study period. Only one patient was hospitalized after starting depot olanzapine.CONCLUSION:Olanzapine LAI is mostly used in patients with a history of non-compliance. Olanzapine LAI is associated with a significant reduction in the severity of illness.

Electroconvulsive therapy (ECT) is one of the safest treatment options for psychiatric illnesses with no absolute contraindications. However, certain medical conditions including cardiac ailments such as aortic stenosis are associated with increased risk with ECT. We present the case of a 74-year-old female who was suffering from severe depression with psychotic symptoms (which had not responded to two adequate trials of antidepressants), along with severe aortic stenosis, who was managed with modified bilateral ECT and review the available literature.

Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. [email protected]; Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India

There is limited literature on olanzapine-associated thrombocytopenia. In this report, we present a case of a 32-year-old female, suffering from persistent delusional disorder who had thrombocytopenia (46,000/mm(3)) with the use of olanzapine 25 mg/day, 6 weeks after starting medication. Blood film did not reveal any evidence of any dysplastic cells, disturbance in the count of other cell lines, and autoimmune workup including antinuclear antibodies and anti-neutrophil cytoplasmic antibodies were found to be negative. Given no other etiology, olanzapine was gradually tapered, and platelet counts were monitored. Reduction in the dose of olanzapine led to an improvement in platelet counts which reached the normal range after complete stoppage of olanzapine. In view of continued psychotic symptoms, she was started on clozapine and which was gradually increased to 200 mg/day with biweekly monitoring of total platelet counts before each increment in the dose of clozapine. Thrombocytopenia did not recur with use of clozapine. With clozapine, her psychosis improved by nearly 60%. A review of literature revealed only eight case reports supporting the association of olanzapine and thrombocytopenia.

Background: CT has evolved from single–detector row scanners into multi–detector row helical volumetric acquisition techniques, and these advances have had a significant impact on imaging of the urinary tract. Aim and objectives: To evaluate the CTU compare to other imaging modalities for urinary tract abnormalities in light of present knowledge, To study the role of CTU in evaluation of various abnormalities those are not detected by conventional IVP, Benefits of CTU over IVP, To provide information about the extent of the lesions involving kidneys and its relation to surrounding structure and Characterizing the lesions whether they are benign or malignant and helping the surgeons for the further management, Grading the renal injuries. Materials and methods: Data was collected from patients who attended the surgical O.P.D. or emergency of S.S.G.H., Baroda with clinically suspected renal abnormalities. A study was conducted over a period of two years on 50 patients with clinically suspected renal abnormalities. Informed consent was taken from every patient. Patients were evaluated with Multidetector Computed Tomography (G.E. Bright Speed). Results: Our Study included 10 patients of renal stones, 8 patients of renal masses, 3 patients of pyelonephritis, 7 patients of renal injury, 5 patients of PUJ obstruction, 7 patients of ureteric stricture, 5 patients of anomalies, and 5 patients of bladder mass. Among all pathology CT urography is more helpful and gives better imaging findings as compare to conventional urography that helps in better management of patients. Conclusion: CTU gives reliable information not about the extent of lesion but also the characteristics of lesions which makes surgeons to take proper decision aboutthe further management of patients, it also avoids unnecessary laparotomy surgery in case of blunt abdominal trauma patients by giving the precious extent of renal injuries. For all these gold standard benefits of MDCTU over conventional Rathva AM, Singla H. MDCT urography as a one stop shop for urinary tract abnormalities at present era. IAIM, 2016; 3(3): 52-64. Page 53 IVP makes MDCTU as “one stop shop” for urinary tract abnormalities and nearly completely replacing the IVP in recent era.

Background: Tuberculosis of the brain and spine is a very severe disease and causes increased rate of mortality and morbidity. Its diagnosis is a challenge for physicians worldwide. Patients of different age groups and having varied socio evaluated successfully to help the physician with further management of the condition. Aim: To estimate role of CT scan and MRI in diagnos Material and methods: Patients referred to th symptoms, coincidental finding of neurotuberculosis or even those with already diagnosed cases of neurotuberculosis which needed follow up radiological investigations were evaluated with either CT or MRI or sometimes both (These were performed on 1.5 T Philips MRI and Seimens 16 Slice MDCT machine). Results: Patients with intracranial tuberculosis mainly presented with tuberculous meningitis and tuberculomas. Most patients suffering from spinal infection presented with Pott’s spine. lesions were paradiscal with involvement of the articular discs. the diagnosis of intracranial tuberculosis. MRI is also very sensit tuberculosis. However, CT plays no role in the diagnosis of spinal tuberculosis. Conclusion: There is a wide spectrum of manifestations associated with intracranial and spinal tuberculosis. Tuberculous meningitis and Pott’s s intracranial and spinal tuberculosis respectively. MRI was more sensitive in the diagnosis of intracranial tuberculosis as compared to CT. CT had no significant role in the diagnosis of Spinal tuberculosis. Hence, MRI is the preferred choice of investigation while evaluating neurotuberculosis. 2, Issue 6, June, 2015. 1 , Himanshu Singla 3 , Shreedevi B Patel 4 3 3 rd year Resident, 4 Professor, Anupsingh Dhakre, Himanshu Singla, www.iaimjournal.com Accepted on: -economic status suffer from neurotuberculosis which need to be is of tuberculosis of brain and e Radiology Department with any kind of neurological MRI is more sensitive than CT scan in ive in the d pine were the commonest manifestations of ISSN: 2394-0026 (P) ISSN: 2394-0034 (O)

Slipped capital femoral epiphysis is a disorder of the hip that affects children in early adolescence, characterized by medial and posterior displacement of the proximal femoral epiphysis on the metaphysis. Although the diagnosis and treatment of slipped capital femoral epiphysis have been well described, the search for continues. We have reported here as an unusual presentation in one family imbalances or endocrine abnormalities; had good nutrition; and presented with atypical characteristics of slipped capital femoral epiphysis.

Aim: To evaluate the features, pattern and extension of the different pathologies affecting the knee joint with help of MRI scans. Materials and methods: This study was performed using MRI scan 1.5 tesla of knee joint in 65 patients. Routine blood investigations were documented in all patients. Results: Distribution of pathologies according to p was observed and p-value of knee joint tears by using MRI as gold standard Conclusion: MRI scans have proved to be successful modality in evaluating the knee joint; MRI results increased the physician’s confidence in the diagnosis. MRI is an excellent noninvasive modality in imaging of the knee and a noninvasive replacement for arthrography a therapeutic arthroscopy.

Slipped capital femoral epiphysis is a disorder of the hip that affects children in early adolescence, characterized by medial and posterior displacement of the proximal femoral epiphysis on the metaphysis. Although the diagnosis and treatment of slipped capital femoral epiphysis have been well described, the search for continues. We have report ed here as an unusual p resentation in one family imbalanc es or endocrine abnormalities; had good nutrition; and presented with atypical characteristics of slipped capital femoral epiphysis.