Role of coping strategies and attitudes in mediating distress due to hallucinations in schizophrenia

The purpose of the present study was to determine the role of coping strategies and attitudes in predicting distress due to hallucinations in schizophrenia. Seventy-five chronic stable schizophrenia patients were assessed with respect to sociodemographic profile, clinical variables, general psychopathology, phenomenology (severity) of hallucinations, attitude towards hallucinations, distress due to hallucinations (determined by two measures) and coping strategies used to deal with hallucinations. On multiple stepwise regression analysis, 'severity of hallucinations' and 'problem-solving coping strategies' contributed significantly to both measures of distress. It can be concluded that distress due to hallucinations in schizophrenia is determined by severity of hallucinations (stressor) and problem-solving coping strategies. Attitudes do not seem to play any role in this respect.     

A Canadian multicenter trial assessing memory and executive functions in patients with schizophrenia spectrum disorders treated with olanzapine

Serial verbal learning task (explicit long-term memory) and verbal fluency (generation of a response) are tests that are usually severely impaired in schizophrenia. Despite the growing literature supporting the clinical efficacy of olanzapine, psychiatrists still question its cognitive consequences. This study assessed the efficacy of olanzapine on neurocognitive functioning. Patients (N = 134) meeting diagnostic criteria for schizophrenia, schizophreniform, or schizoaffective disorders began an 8-week, open-label olanzapine treatment at a dose of 5 mg/d, which was increased to 10 mg/d after 1 week. Daily dosage was subsequently adjusted between 5 and 20 mg/d based on individual clinical status. All previous antipsychotics were tapered and discontinued during the first 2 weeks of the study. Neuropsychologic assessments were carried out at baseline and at 4 and 8 weeks. Explicit long-term memory was assessed with the Rey Auditory-Verbal Learning Test: the average immediate recall score significantly improved (P < 0.001), as did the delayed recall score (P < 0.001). The average total score on category fluency improved from 34.6 words at baseline to 37.6 words at end point (P < 0.0001). Time on both Trail A and B making tasks significantly decreased (P < 0.0001). Lack of a control arm makes it impossible to exclude a practice effect as an explanation for the enhanced cognitive performance, although the Word List Recall test represents one of the better resources to avoid a practice effect. After switching to olanzapine, there was a statistically significant improvement of cognitive function in the 3 main domains tested and no significant worsening of any memory or executive function measure.     

Pesticide bioaccumulation and plasma sex steroids in fishes during breeding phase from north India

The investigation was done to monitor the total hexachlorocyclohexane (∑HCH) and total dichlorodiphenyltrichloroethane (∑DDT), aldrin, endosulfan and chlorpyrifos in liver, brain and ovary, gonadosomatic index (GSI) and plasma levels of testosterone (T) and estradiol-17β (E2) during breeding season of captured catfishes and carps from the unpolluted ponds of Gujartal, Jaunpur (reference site) and polluted rivers Gomti, Jaunpur and Ganga, Varanasi. Results have indicated that catfishes have higher bioaccumulation of pesticides than the carps, which was beyond the permissible limits for ∑HCH whereas ∑DDT only by catfishes of polluted rivers. The GSI and plasma levels of T and E2 were lowered in the fishes captured from the polluted rivers. In conclusion, the fishes from river Gomti and Ganga showed a high degree of contamination and disrupted reproductive axis when compared to those from the reference site reflecting the degree of pesticide pollution present in those water bodies.     

A randomized masked pilot clinical trial to compare the efficacy of topical 1% voriconazole ophthalmic solution as monotherapy with combination therapy of topical 0.02% polyhexamethylene biguanide and 0.02% chlorhexidine in the treatment of Acanthamoeba keratitis

PurposeTo compare the efficacy of topical voriconazole 1% and the combination therapy of 0.02% polyhexamethylene biguanide (PHMB) and 0.02% chlorhexidine for the treatment of Acanthamoeba keratitis (AK).MethodsThis is a prospective, pilot, double-masked randomized comparative study. Twenty-three eyes of 23 patients with microbiologically (smear and/or growth on culture) confirmed AK were randomized to group BG (PHMB 0.02% and chlorhexidine 0.02%) or group VZ (voriconazole 1%). Primary outcome measure was change in geometric mean (GM) of the corneal ulcer size at final visit. Secondary outcome measures were change in visual acuity.ResultsOut of 71 patients with confirmed AK seen during study period, 23 patients were recruited and 18 patients completed minimum 2 weeks of treatment and further analyzed. Ten patients received BG, whereas eight received VZ. Median ulcer size measured as GM of infiltrate decreased from 5.7 mm (IQR, 5.3–6.5 mm) (p = 0.02) to 1 mm (IQR, 0–4.3 mm) in group BG and from 4.5 mm (IQR, 1.8–5.1 mm) (p < 0.05) to 0.7 mm (IQR, 0–1.6 mm) in VZ group. Median visual acuity improved from 1.79 (IQR, 1.48–2.78) to 1.10 (IQR, 0.48–1.79) in BG group (p = 0.02) and from 1.60 (IQR, 1.00–2.78) to 0.80 (IQR, 0.48–1.30) in VZ group (p = 0.18).ConclusionThese outcomes suggest that topical VZ as a monotherapy in AK treatment is effective and comparable to BG combination therapy but needs trials with larger sample size and longer follow-up to provide conclusive evidence.Subject terms: Corneal diseases, Parasitic infection     

Test Controller Design, Implementation, and Performance for a Magnetic Suspension Continuous Flow Ventricular Assist Device

A new continuous flow ventricular assist device using full magnetic suspension has been designed, constructed, and tested. The magnetic suspension centers the centrifugal pump impeller within the clearance passages in the pump, thus avoiding any form of contact. The noncontact operation is designed to give very high expected mechanical reliability, large clearances, low hemolysis, and a relatively small size compared to current pulsatile devices. A unique configuration of magnetic actuators on the inlet side and exit sides of the impeller provides full 5 axis control and suspension of the impeller. The bearing system is divided into segments which allow for 3 displacement axes and 2 angular control axes. The controller chosen for the first suspension tests consists of a decentralized set of 5 proportional integral derivative (PID) controllers. This document describes both the controller and an overview of some results pertaining to the magnetic bearing performance. The pump has been successfully operated in both water and blood under design conditions suitable for use as a ventricular assist device.     

Mast cell in leprosy

Mast cell distribution in the affected skin and in the apparently normal skin at least 10 cm away from the lesion was studied in 250 leprosy patients. These cells were found and were more numerous in the apparently normal skin of established cases of leprosy as well amongst indeterminate group. Absence of mast cells was conspicuous in 16.7% LL, 41.7% BB, 40.9% BT, and 68.0% TT lesions. It is suggested that mast cells might play a role in the early stages of the disease and in postreactional connective tissue proliferation.     

Comparison over short term of mortality and morbidity of mechanical and bioprosthetic heart valves in the Indian population

Background  

Choice of heart valve in the developing countries is an unsettled issue due to illiteracy and noncompliance related increase in incidences of stuck valve and anticoagulant related bleeding and as such international guidelines may not be wholly applicable. The aim of our study was to compare outcomes after mitral, aortic or double valve replacements with mechanical versus bioprosthetic valves.