Department of Pulmonary Medicine, King George’s Medical University, Lucknow-226003, UP; Naturopath, Institute of Human Consciousness & Yogic Sciences, Lucknow University, Lucknow-226005, UP; Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow-226003, UP E-mails: saishruti.agnihotri@gmail.com; dr.kantskt@rediffmail.com; satyendramishra.yoga@gmail.com; narayanrenu@yahoo.com
We present two cases of recurrent progressive multifocal leukoencephalopathy (PML) in patients with long standing virally suppressed human immunodeficiency virus (HIV) and normal CD4+ T cell count who were taking stable regimens of highly active antiretroviral therapy (HAART). This has significant implications for other patients with a past history of PML, not just those with HIV but also those on medications such as natalizumab or fumarates.
Objective: To describe the first case of spontaneous Serratia marcescens monoinfection in CSF in an adult with intravenous drug abuse. Background: Gram negative rods are an uncommon cause for meningitis. A rise in nosocomial gram negative bacillary meningitis has been observed. Serratia is a described pathogen for acute cerebrospinal fluid (CSF) infections in neonates and iatrogenic cases. Design/Methods: NA Results: We report this case of a 53 year old male with active intravenous drug use (IVDU) and no previous neurosurgical procedures, who presented with altered mental status and gait instability for 2 weeks along with headache, nausea and vomiting for 2 months. CT scan revealed hydrocephalus requiring urgent placement of an intraventricular catheter. Initial CSF analysis revealed glucose of Conclusions: Serratia marcescens is an extremely rare cause of acute meningitis in adults and reported cases have a history of cranial, spinal or otic manipulation. On the contrary, our patient had an insidious onset of meningitis resulting in hydrocephalus with no prior procedures. His IVDU was likely a risk factor, though there was no evidence of bacteremia. Atypical organisms in CSF can often be disregarded as contaminants. This can delay therapy and increase morbidity and mortality. Our case highlights an atypical presentation of meningitis caused by a rare organism. Disclosure: Dr. Humayun has nothing to disclose. Dr. Agnihotri has nothing to disclose.
Introduction: Delusion of misidentifications are characterized by delusional belief that familiar person, objects, or self have been replaced or transformed. There are four common types like Capgras syndrome, Fregoli syndrome, Syndrome of subjective doubles and syndrome of intermetamorphosis. Another type of delusion of misidentification is mirrored self- misidentification, where the delusional belief is that one’s reflection in the mirror is misidentified as a stranger. Case report: A 83 years old male patient Mr. X, graduate, married, retired from his job, belonging to middle socio-economic status, hailing from urban background was accompanied to the OPD by his daughter. Informant had complaints of suspiciousness, abusing family members, abnormal behavior, and memory impairment since 6 months. Patient started suspecting that there is stranger whenever he looked into the mirrored or any other reflecting surfaces. Later he started suspecting that stranger was coming to meet his wife. Apart from this he also had memory disturbances. All the investigations were normal and he was started on Tab. Quetiapine -25mg and Tab. Donepezil -5mg. Discussion: The ability to recognize oneself in the mirror has a potential way of testing self-awareness, but it is not clearly known how the brain does it. Mirrored-self misidentification has rarely been described in the literature. Most of the reported patients have global dementia of the Alzheimer type, making it difficult to infer the anatomical basis of this disorder. Conclusion: The loss of the ability to recognize oneself in the mirror is evidence of a fundamental change in the sense of self and this may cause interpersonal problems as well. Managing such cases may be difficult and challenging.
Introduction: Electro-convulsive therapy is a brain stimulation technique which results in a seizure activity when electrical stimulus is applied. It is indicated for disorders like depression, bipolar disorder, schizophrenia and catatonia and in cases where pharmacotherapy has failed. It can cause side effects like cardiovascular problems, cognitive impairment and mania. Case report: A 19years old male patient, Mr. A, presented to the OPD with parents. Patient was mute. Informants had complaints of decreased interaction, prefers to be alone, sitting idly, poor self-care since one year and maintaining postures for long hours, not speaking anything, and disturbed sleep since one month. He was diagnosed as Catatonic Schizophrenia and was started on Inj. Lorazepam 2mg BD, ECT was started. After receiving 2 ects patient was showing manic symptoms. He was started on Tab. Olanzapine -10mg and 8 ects were continued. Discussion: ECT is a very effective treatment in cases of catatonia. ECT induced manic switch in depressed patients is considered as Bipolar I. There are no case reports suggesting ECT induced mania in catatonic schizophrenia. Conclusion: It is relatively common to see ECT induced mania in depressed patients, but the case discussed above has a rare nature. The exact mechanism for this remains to be unclear and a matter of research.
Breathing sustains life, natural breathing brings happiness and keep healthy. It clears the mind and calms all the emotions hence it can helps in release of the vitalizing flow of energy within us. Air pollution is responsible for various respiratory diseases such as nasal allergy, asthma, chronic bronchitis and lung cancer. It has been found that Yoga has improved pulmonary parameters in several scientific studies, both in healthy as well as in diseased individuals. It helps in increase in vital capacity, tidal volume, FeV1, Fev1/FVC ratio, expiratory reserve volume, breath holding time and many other pulmonary parameters. These changes suggest a potential preventive and therapeutic role of yoga in pulmonary diseases.It is a method of learning which aims to attain the unity of mind, body and spirit through three main yoga steps includes exercise, breathing and meditation. Results of previous research studies report that many people with serious respiratory ailments have found a solution in yoga. It has been proventhattheyogic practices help in prevention, control as well as rehabilitation of many respiratory diseases. A vital scientific and therapeutic aspect of yoga is Pranayama. Few exercises of pranayama are like Anulomaviloma, Kapalbhati, Bhramari which are the components of yoga and are the best remedies which can be help to tackle respiratory illness caused by air pollution and other naturally occurring respiratory diseases.
Sarcoidosis is an idiopathic multisystem granulomatous disorder. Neurologic manifestations in sarcoidosis are varied and making a diagnosis of neurosarcoidosis can be difficult as it mimics various other neurologic diseases. Knowledge of the syndromes associated with neurosarcoidosis can help guide the diagnostic evaluation. Definitive diagnosis requires neurologic tissue evidence of noncaseating granuloma, but in practice probable diagnosis is often made through nonneurologic biopsy and a characteristic syndrome and imaging. Treatment remains empiric, but new advances in immunologic therapy hold promise for effective and less-toxic regimens.
Background: Emotional intelligence refers to ability to monitor own and other people's emotions. Lack of emotional intelligence can lead to many disturbances in one's life. A comparison of emotional intelligence in offenders with antisocial personality disorder and in normal population has been done in this study. Aim: The aim is to study emotional intelligence in offenders with antisocial personality disorder and compare it with normal population at a tertiary care centre in Hyderabad. Methodology: It is a cross-sectional and comparative study done at Institute of mental health, Hyderabad. Study sample includes 70 males, out of this 35 were offenders diagnosed with antisocial personality disorder and remaining 35 were from normal population. Tools used in this study are semi-structured intake pro-forma for sociodemographic details and criminal history, Goldberg's 12 item General health questionnaire, Mangal emotional intelligence inventory, International classification of diseases-10 criteria. Results: The offenders group with antisocial personality disorder scored less on emotional intelligence test domains such as intrapersonal awareness, interpersonal awareness, intrapersonal management, interpersonal management and the total emotional intelligence score when compared to normal individuals and the difference between the two groups was found to be statistically significant. (p = 0.000). Conclusion: The offenders with antisocial personality had significantly lower Emotional intelligence in comparison to the normal group and an inverse relation was observed between levels of emotional intelligence and number of crimes committed. Keywords: Emotional intelligence, Antisocial personality disorder, Criminal offenses.
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