Aim:To assess the incidence of cutaneous lesion in bipolar affective disorder (BPAD) patients on lithium therapy. To evaluate the relationship between duration of lithium therapy, dosage of lithium, serum lithium level, and cutaneous lesions. To assess whether reduction/stoppage of dose of lithium has any change in the course of cutaneous side effects. To look for a relationship between addition of isotretinoin and the course of mood disorder.Methodology:We retrospectively collected hospital case records of 125 consecutive BPAD patients initiated lithium therapy, assessed with inclusion and exclusion criteria. We follow up them for 2½ years for the assessment of above said aims.Results:The prevalence of skin reaction in BPAD patients with lithium therapy was 19.8%. Among patients on lithium therapy, cutaneous lesion emerged in initial 6 months and later after 1 year of treatment. Nearly 55% of patients on higher doses of lithium (1200 mg) had a cutaneous lesion. Patient on therapeutic serum level of lithium had a higher incidence of skin lesion. Out of six patients in whom dosage of lithium was reduced, three of them had reduced lesions (P = 0.6), in two patients, skin lesion increased, and one patient had no change. Among 11 patients treated with isotretinoin, only two patients had emergence of depressive symptoms.Conclusion:Lithium continues to increase the incidence of multiple cutaneous lesions among BPAD patients on lithium therapy. Incidence of cutaneous side effects directly correlates with the dose of lithium and therapeutic range of serum lithium level. Altering the dose of lithium does not statistically influence the cutaneous lesion.

Background: The easy availability of various gadgets with the provision of faster internet at affordable prices has exponentially increased internet usage in the past few years. This study aimed to estimate the prevalence of internet addiction and describe its association with disordered eating in medical college students. Methods: This crosssectional study was conducted on 300 medical college students in south India. After obtaining ethical clearance and informed consent, students were given a questionnaire containing sociodemographic variables, Young's Internet Addiction Test (IAT), and Eating Attitudes Test questionnaires (EAT). Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency, and proportion for categorical variables. Categorical outcomes were compared between study groups using the chi-square test. Univariate binary logistic regression analysis was performed to test the association between the variables. Results: The prevalence of internet addiction was 46.7% in this study. Disordered eating was found to be 12.3% in medical students. Internet addiction was observed to be more in the younger age group. (P <0.001) A significant association was obtained between internet addiction and disordered eating. (P <0.05). Conclusion: Nearly half of the medical students in this study were addicted to the internet, and disordered eating was also high among medical students. A closer look into the aspects like internet addiction and eating disorders is required, as these may silently impact the life and productivity of the budding doctors.

Intellectual disability is a known condition, but psychosis and its extension in functional areas of life, with episodes of seizures in between, make the case complex and leave clinicians with a limited choice of treatment and unpredictable outcomes. We present the case of a 20-year-old female with intellectual disability, episodes of seizures, and pattern of psychosis, with its course describing the perplexity of the treatment in the area of its outcome predictability, which also highlights the lack of a structured approach for clinicians’ guidance in managing it as a multidisciplinary field.