There was substantial heterogeneity in the use of ECT between participating centers, indicating that the Network is representative of modern ECT practice. The Clinical Alliance and Research in ECT Network may therefore offer the opportunity to improve service delivery and facilitate the investigation of unresolved research questions pertaining to modern ECT practice.

Majority commencing RUL-UB switched and received 4-5 more treatments compared to bilateral placements. RUL-UB ECT appears less effective and might not be appropriate as first line for all older adults as some patients at higher anaesthetic risk would benefit from having reduced number of treatments.

Mutations within transpeptidase domain of penicillin‐binding protein 2B of the strains of Streptococcus pneumoniae leads to resistance against β‐lactam antibiotics. To uncover the important residues responsible for sensitivity and resistance, the recently determined three dimensional structures of penicillin‐binding protein 2B of both wild‐type R6 (sensitive) and mutant 5204 (resistant) strains along with the predicted structures of other mutant strains G54, Hungary19A‐6 and SP195 were considered for the interaction study with β‐lactam antibiotics using induced‐fit docking of Schrödinger. Associated binding energies of the complexes and their intermolecular interactions in the binding site clearly show that the wild‐type R6 as sensitive, mutant strains 5204 and G54 as highly resistant, and the mutant strains Hungary19A‐6 and SP195 as intermediate resistant. The study also reveals that the mutant strains Hungary19A‐6 and SP195 exhibit intermediate resistant because of the existence of mutations till the intermediate 538th and 516th positions, respectively, and not till the end of the C‐terminus. Furthermore, our investigations show that if the mutations are extended till the end of the C terminus, then the antibiotic resistance of induced‐mutated strains increases from intermediate to high as in the strains 5204 and G54. The binding patterns obtained in the study are useful in designing potential inhibitors against multidrug resistant S. pneumoniae.

Electroconvulsive therapy (ECT) is an effective treatment of mania. Ultrabrief ECT is a novel modality that is associated with fewer cognitive adverse effects than the standard pulse width brief pulse ECT. It has been well studied in depression. However, its use in mania is not yet known. Following a retrospective chart view, we report a small sample of patients who had Right Unilateral Ultrabrief ECT (RUB-ECT) for mania. Eleven RUB-ECTs were identified for 9 patients; 72.8% remission rate was observed with RUB-ECT. Two patients required switch into bitemporal ECT in view of minimal clinical response and 1 patient to right unilateral brief pulse ECT because of poor seizure parameters. All patients achieved remission eventually. The possible mechanisms of ECT in mania and clinical implications of ultrabrief ECT are discussed.