Friday, April 27, 2018

ON Neurobiology in Psychiatry

We will be trying to put certain discussions from Mental Health Professionals to this Platform

Neurobiology has been on backfoot in Psychiatry and we want to put it in place where it should be... i.e. right on top

Concepts in Psychiatry are very much scientific and measurable in Neurobiological terms.

And before we proceed, one declaration!
By being vehemently in search of neurobiological basis and explanations, we do not become anti of Psychological interventions.

Psychological interventions are good. And are mild/ mod neuromodulations technique (different names for different people )

By promoting neurobiology we don't become pill pushers. Neurobiology doesnt mean  advovating medications over every thing else.

Neurobiology needs to be understood to take the cause of our branch further.

We are just in search of truth that still eludes us🙏🏻

From the team of "Live CME Psychiatry"

Monday, May 25, 2015

Hidden Habits in Children: How to Handle

https://youtu.be/V51pgVlNVpA?t=4m17s

Topic: Hidden Habits in Children: How to Handle
Expert: Dr Aleem Siddiqui



https://youtu.be/V51pgVlNVpA?t=4m17s

This is Youtube link to the telecast on ETV-Uttar Pradesh, ETV-Madhya
Pradesh, ETV-Bihar/Jharkhand at 3.30 pm and on ETV-Rajasthan at 1:30 pm;
on Thursday, 14th May 2015


Sunday, May 24, 2015

MEN-O-PAUSE: The Andropause, the male menopuase.


Menopause in females is a well delineated and abrupt of decline of estrogenic hormones, and reproductive function, somatic and psychological functions.

Whereas ANDROPAUSE in males is a controversial concept: not widely accepted.

In males andropause there is a gradual decline of functioning. As described by Morales and Lunenfeld (International Society for the Study of the Aging Male) it’s a “biochemical syndrome associated with advancing age and characterized by a deficiency in serum androgen levels with or without a decreased genomic sensitivity to androgens”

The decline in testosterone with aging is related to decreases in both hypothalamic (HPA axis less sensitive, less GNRH-less LH) and testicular function (Leydig cells decrease)

There is a   lack of established normal testosterone levels for different age groups (Approx 1-2% decline from 40-70yrs)

For now it’s a diagnosis of exclusion after ruling out other causes of gonadal dysfunction like medication side effects, thyroid problems, depression and excessive alcohol use, obstructive sleep apnea.

Diagnosis is based on the psychological and cognitive hints of andropause including loss of cognitive function, depression, and “loss of drive”, chronic fatigue, lethargy, hot flashes, ED, decrease libido,  ?midlife/latelife crisis. On Physical Examination there decrease in lean body mass(l ess muscles and more fat) and changes in hair, skin, and fat distribution, osteopenia and osteoporosis.
Plus a low testosterone level (a concomitant raised LH indicates testicular deficiency)

Testosterone replacement Therapy(TRT) in this population is anabolic,  including increase in lean body mass and associated decrease in fat mass, increased bone mineral density, increase in muscle strength and sexual function, improved generalized feelings of well-being, and improved cognitive function

Side effects of TRT being Promotion of fluid retention, Increase in cardiovascular disease risk, Precipitation or worsening of sleep apnea, Gynecomastia, Polycythemia, Fluctuations in mood, Worsening of pre-existing prostatic disease(possibly does not induce)

There is absence of long-term placebo-controlled trials of TRT.

A few points of cation: Andropause is not a widely accepted construct, is not universal as female menopause. There is lack of age appropriate standardized values of serum testosterone. When its there, its very gradual in onset and difficult to detect.

Sunday, October 27, 2013

35th Annual Conference of Indian Psychiatric Society- Central Zone (CIPCON 2013)

https://www.facebook.com/media/set/?set=a.10200770781538579.1073741827.1433892854&type=1&l=f4ad2876ec

Dear friends
The 35th Annual Conference of central zone of IPS (CIPCON 2013) was held at Lucknow on 19-20th October 2013. The theme was ‘Psychiatry Beyond the Books’
Org Chairman: Dr Ajay Kohli
Org Secretary & Treasurer: Dr Mohd Aleem Siddiqui

Dr AK Agarwal was the Chief Guest, and Dr T Prabhakar, VSM was the guest of honour. Politicians and flowers were kept out. Dr Shashi Rai took over as president from Dr SB Joshi. Conference souvenir was released.

10 invited faculty lectures were delivered in the CME and Symposia for which 6 CME credit hours were awarded by UP Medical Council.
The leading speakers like Dr. Chitranjan Andrade, Professor of Psychopharmacology NIMHANS, Bengaluru and Dr. S. Haque Nizamie, Professor of Excellence, CIP, Ranchi, Dr. Rajni Chatterjee, Prof. & Head of dept. Of Psychiatry, Bhopal Memorial Hospital and Research Centre, Bhopal, Dr H Naidu, Senior Consultant at Noormanzil Hospital, Lucknow, Dr. Ram Ghulam Razdan , Founder and Head of the dept of Psychiatry, MGM medical college, Indore, Dr. P.N Shukla, founder and Director PGIBAMS, Raipur, Chattisgarh, Dr U C Garg, Senior Practitioner of Agra,  Dr Shazia Veqar Siddiqui -Ex- Head of Department of Clinical Psychology, CIP, Ranchi, Dr Vivek Agarwal  and Dr Srikant Srivastava of KGMU delivered the talks.
22 research papers were read. Best paper award was won by Dr Sreeraj and Tara Naidu award by Dr PP Singh. BB Sethi oration was delivered by Dr Rajeev Jain.
An Openhouse session was held where questions were put in a fishbowl and were answered by the house.
All the sessions were very well attended, timely and good academic discussions took place. (more people in halls than in cafeteria!). Banquet at Hotel Clarks Awadh had nearly 400 guests with lots of laughs and reunion. Hope every one left with pleasant memories.
It was a very satisfying experience, specially for myself.

Wednesday, July 11, 2012

Alcohol and Drug Addictions

What are alcohol and substance related problems?
Alcohol or substance related disorders are the conditions arising from the misuse or excessive use of alcohol, psychoactive drugs and other chemicals including charas, ganja, heroin, cocaine, etc.

When to call someone suffering from alcohol or substance related problems?
The continuous use of different types of drugs or alcohol gives rise to various problems in physical health as well as social and occupational life of a person. a person is diagnosed as having alcohol or substance related problems when:
ü  Person gets a strong desire to take alcohol or other drugs. The desire is so strong that a person feels compelled to take it,
ü  Person cannot control himself from taking drugs or as he losses the sense of when to stop taking it, or when he get completely intoxicated and need to curtail the intake,
ü  Person experiences extreme discomfort, restlessness, dizzy, body ache, disturbed sleep, tremors, nausea or other symptoms when tries to stop taking or reduces the amount of drug or substance,
ü  Person requires larger amount of alcohol or drug to get the same level of effect. The effect that he used to feel from small amount is not achieved with same amount of drug after some time,
ü  Person starts neglecting other interests and activities because he invests more time in obtaining the drug,
ü  Person continues to take drug or substance even after knowing clear, harmful consequences as accidents, physical problems or death.

What all things can cause such problems?
Most of those chemical or natural products that affect our central nervous system (Brain and other related system) have some capability of causing these problems. Such as:
  1. Alcohol , “Desi sharab”, “Taadi”, Wine, Bear, Vodka, Gin, “Mahua”, “Hadia” etc;
  2. Tobacco, “Khaini”, “Gul”, Ciggarette, “Bidi”, etc;
  3. Opioids, “Brown sugar”, “Chase”, Opium, Heroine, “Charas”, “Cough Syrups”, “Spasmodic pain reliever”  etc;
  4. Cannabis, “Bhang”, “Rocket”, “Ganja”, “Hukka”, etc;
  5. Volatile solvents, “Thinner”, “Whitener”, “Paint”, “Petrol”,     
  6. Steroids,
  7. Hallucinogens,
  8. Sedatives, Tranquillizers

What is the harm in taking such drugs?
These drugs may lead to following consequences:-
Immediate consequences-
  1. Loss of control over body movements
  2. Nausea,
  3. Vomiting,
  4. Restlessness,
  5. Tremors,
  6. Dry mouth,
  7. Increase heart beats,
  8. Sweating,
  9. Irregular breathing,
  10. Irritability etc.
Long term consequences-      
  1. Damage to brain leading to psychiatric problems,
  2. Deficiency of protein and vitamin B from the body,
  3. Liver damage,
  4. Increase susceptibility to infections,
  5. Gastritis,
  6. Peptic ulcers,
  7. Acute or chronic pancreatitis,
  8. Hepatitis,
  9. Cirrhoris,
  10. Hepatoma,
  11. Death, etc
Psychological consequences-
  1. Anxiety,
  2. Depression,
  3. Memory problems,
  4. Sleep disturbance,
  5. Lack of interest in work, etc.
Social Consequences-
  1. Marital disruptions,
  2. Loss of social status,
  3. Familial discords,
  4. Problems at work place,
  5. Financial loss, etc.

What are the causes of alcohol related illnesses?
The causes of alcohol and drug related illnesses are divided in three major categories:
Biological Causes:
ü  Heredity or genetic causes: In person who has family members who had similar problem, have more chances of acquiring tolerance and vulnerability to take alcohol as compared to the other with no such background,
ü  Presence of any other psychiatric illness specially anxiety related,
ü  Presence of physical illnesses causing intense discomfort and pain,
ü  Experience of “high” and elevated, cheerful mood due to intake,
ü  Bodily discomforts, pains, tremors, disturbed breathing and disturbed heart beat when alcohol, drug is not taken, etc.
Psychological Causes:
ü  Curiosity, sensation seeking behavior,
ü  Social rebelliousness,
ü  Poor stress management,
ü  To get over with fatigue or boredom,
ü  Poor self-control,
ü  Trauma or recent loss, etc.
Social Causes-
ü  Pressure from friends,
ü  Imitation of actors or elders who take alcohol,
ü  Easy availability,
ü  Poor family bonding and support,
ü  Religious reason,
ü  Faulty concept of modernization, etc.

Is it habit, bad character, or something else?
Addiction, alcohol abuse, drug abuse are not simply habits or are part of bad character but it is an ILLNESS or PSYCHOLOGICAL DISORDER, which has some identified biological and other causes, and which is TREATABLE.
 
What can family do to help this illness?
The family has a major role in the treatment of this condition,
ü  For identification and evaluation of the problem,
ü  For leading and motivating patient,
ü  For arranging treatment facilities for patient,
ü  For supporting and expressing faith in the patient,
ü  And for boosting self-esteem and self-efficacy of the patient.

What is the treatment of this condition?
The treatment of this condition is divided into two parts
Biological:
ü  It includes detoxification, which is helping the patient to stop the consumption of drug/alcohol and manage the physical discomforts that a person may experience due to sudden cessation of drug intake. This process takes only a few weeks.
ü  It also includes helping the patient in reducing the intense desire or craving sensation for drug.
ü  The patient can also be helped by giving certain components which if take regularly cause highly distressing reacting to intake of alcohol and thus prevents person from taking it.
Psycho-Social:
ü  It includes improving persons’ motivation to quit drug/alcohol,
ü  Helping patient to develop skills to control his behavior,
ü  Helping patient to prevent further relapses (restarting drug),
ü  Bringing about changes in person’s life style, stress management, etc,
ü  Involving family members to get support and care,
ü  Helping patient to regain self-esteem, self-efficacy, and self-respect.

Is it curable?
Substance related conditions can be cured with effective treatment but what required is personal motivation to help oneself, good support of family, and professional consultation.