No abstract

Background:Cognitive deficits—the hallmark of schizophrenic deterioration—still remain elusive as far as their pathophysiology is concerned. Various neurotransmitter systems have been implicated to explain these deficits. Abnormalities in cholinergic neurotransmission in the brain are one of the postulations; acetylcholine has also been postulated to regulate rapid eye movement (REM) sleep, especially REM latency. Thus, REM latency in patients with schizophrenia might provide a non-invasive window to look into the cholinergic functions of the brain.Aim:To study REM sleep measures and neurocognitive function in schizophrenia, and the changes occurring in these parameters following pharmacological treatment.Methods:Thirty subjects (15 with schizophrenia and 15 normal non-relative controls) were evaluated in this study. Most patients with schizophrenia had prominent negative symptoms and deficits in the performance in neurocognitive tests battery. They were treated with antipsychotics for a variable period of time and post-treatment evaluation was done using the same battery of neurocognitive tests and polysomnography. Patients were either drug-naïve or kept drug-free for at least two weeks both at baseline as well as at the post-treatment stage.Results:A positive correlation between the severity of negative symptoms and neurocognitive deficits (especially on the Wisconsin Card Sorting), and a negative correlation between these two parameters and REM latency was observed.Conclusion:It can be hypothesized that the acetylcholine deficit model of dementia cannot be applied to schizophrenic dementia, rather a hypercholinergic state results. This state warrants anticholinergic medication as a treatment option for negative symptoms of schizophrenia.

Tramadol has abuse potential (even in therapeutic doses) more than Placebo but less than or comparable to Buprenorphine.

Silpavathi et al.: Challenges and Solutions of Non-classical Herbal FormulationsNon-classical herbal formulations have gained momentum in the recent past. These formulations, however, have not been well integrated with the modern system of medicine in most of the countries in the world. This is due to the lack of enough scientific evidence pertaining to its long-term safety and efficacy. Besides, the paucity of authentic monographs on the impurity profiling, standardization protocols, lack of guideline on the fixed-dose combinations and absence of programmed pharmacovigilance plan for herbal drugs are among the major caveats. In recent years, few issues pertaining to the classical herbal formulations are being addressed to some extent. However, the issues on non-classical modern formulations remain the same. Hence, the objective of this mini-review is to shed light on the major flaws and challenges of these formulations and provide some expert opinion to counter these issues.

Psychiatric morbidity is common in the medically ill children, although it is frequently unrecognized anduntreated. This study was conducted to determine the nature and extent of psychiatric morbidity in childrenwith chronic medical diseases. 100 children attending the different follow-up clinics at a tertiary carepediatric referral Centre were evaluated using Childhood Psychopathology Measurement Schedule (Malhotraet.el.1988). Thirty one percent children showed abnormally high levels of emotional and behavioral problemsindicative of a possible psychiatric disorder. Attendance at Pediatric OPD was associated with an increasedrisk of common type of childhood psychiatric problems with about 21% children scored abnormally high infactor III (Anxiety) & VII (Physical illness with Emotional problems) suggestive of a definitive psychologicaldisorder. The result indicates that about 1/3 rd children attending pediatric follow-up clinics with chronicmedical illness need a formal psychiatric evaluation for certain psychological disturbances. This also advocatesthe provision of a hospital based pediatric psychiatric liaison service that would help to address this needand create opportunities for pediatricians to train in child psychiatry.Key Words: Psychiatric morbidity; children; chronic medical illness.