After traumatic brain injury (TBI), the most disabling problems are generally related to neuropsychiatric sequelae, including personality change and cognitive impairment, rather than neurophysical sequelae. Kluver-Bucy syndrome (KBS) is a rare neurobehavioral condition, first described in 1937 as an experimental neurobehavioral syndrome in monkeys with bitemporal brain lesions. The syndrome in man was subsequently observed to be transient or permanent in a variety of neurodegenerative disorders and after traumatic, nontraumatic and infectious brain injury. However, partial KBS may occur in the absence of the classic bilateral temporal lesion, though rare. Pharmacological treatment of post-TBI neuropsychiatric sequelae consists of symptomatic, functional and hypothetical approaches. Specific pharmacological treatment consists of antipsychotics, anti-kindling anticonvulsants or a combination thereof. A case of partial KBS presenting as delayed manifestation of traumatic brain injury that improved with carbamazapine and antipsychotics is presented.

Bacterial infections are frequent complications in patients with chronic liver disease (CLD). A potential source of infection may be dental foci. This study was carried out to assess the association of CLD with dental caries and periodontal disease. Dental caries and periodontal examinations were performed prospectively in patients with CLD (group A) and controls without any liver disease (group B). Similar examination was also carried out in alcoholics without liver disease (group C) as well as in cases with portal hypertension but no liver disease (group D) i.e. patients with Non Cirrhotic Portal Fibrosis and Extrahepatic portal obstruction. A total of 231 subjects (Group A:83, group B: 75, group C:46 and group D:27) were studied. Group A included 32 cases with chronic hepatitis B&C, 26 with alcoholic cirrhosis, 14 with postnecrotic cirrhosis, and 11 with cryptogenic cirrhosis. Measures of oral hygiene (p < 0.01), dental care (p < 0.001), and periodontal parameters were worse and the number of teeth requiring treatment (p < 0.05) was higher in alcoholics with or without cirrhosis than in healthy subjects and nonalcoholic patients with cirrhosis. Alcoholics had a lower, total number of teeth than patients without alcohol abuse and healthy controls (p < 0.01). The dental caries and periodontal status of patients with nonalcoholic cirrhosis did not differ significantly from group B. The severity and duration of liver disease had no influence on dental caries and periodontal disease. The presence of chronic alcohol abuse rather than cirrhosis or portal hypertension is a major predisposing factor for dental caries and periodontal diseases. In alcoholics, these diseases appear to be caused primarily by bad oral hygiene and poor dental care.

Objective:To assess the attitude of MBBS student toward concept and practice of psychiatry between groups of students exposed to psychiatry rotation versus those not yet exposed to.Materials and Methods:A cross-sectional analytical study was carried out. Anonymity and confidentiality of the respondent was emphasized. Attitude was measured with 30-item “attitude toward psychiatry” scale.Results:Attitude toward psychiatry was found to be better in groups of medical students exposed to 2 weeks clinical rotation in psychiatry. However, the same reached statistical significance in only 36.7% of the questions.Conclusion:Clinical rotation in Psychiatry in undergraduate has a favorable effect on the attitude of medical students toward concept and practice of psychiatry. Better curriculum and more hours in psychiatry may yield better gain.

Tardive dyskinesia (TD), neuroleptic-induced delayed onset movement disorder, remains an enigmatic phenomenon and a therapeutic challenge. Only a few cases of dysphagia also have been reported in world literature and to the best knowledge of the authors no case of TD manifesting as isolated dysphagia has been reported so far from India. We report a case of TD consequent to prolonged exposure to typical neuroleptics, manifesting as isolated dysphagia who responded well to a combination of Quetiapine, Donepezil and Vit E.

Original Article IntroductionR esearchers attempted to assess child behaviour quantitatively and qualitatively but differed from each other in sampling, use of assessment scales, diagnostic criteria and statistics. In the studies conducted over the last fifty years prevalence rate varied from 5% [1] to 51% [2]. In the Indian studies prevalence rate varied from 13 per thousand [3] to 431 per thousand [4]. Analysis at paediatric outpatient departments revealed behaviour problems in the range of 3.36% [5] to 50% [6]. Single parenting and violence have been associated with increased behaviour problems in children [7,8]. Western studies suggested increase in prevalence of behaviour disorder in children of armed service personnel [9] with separation, transiency and differential parenting [10] implicated as predisposing factors. No studies have been undertaken to that effect in military population in India. Material and MethodFifty children of age 6-14 years from paediatric outpatient department of a command hospital were selected after randomisation. Every third patient with either of the parents entering the paediatric out patient department (OPD) complex was included and subjected to child behaviour checklist (CBCL) which was filled by the parents [11]. This checklist (CBCL) is a family of self rated instrument that surveys a broad range of difficulties encountered in children from preschool age to adolescence. It is a multiaxial scale normed by age and gender. Various versions of CBCL were designed to obtain data from parents, teachers and youth. Parent's version of CBCL was used in this study. The cut off scores as given by Achenbach were used in this study (Table 1). ResultsOf the 50 patients studied, 36 (72%) were from the armed forces of which 3 (9%) were siblings of officers. Mean age of the study population was 9.56 ± 2.62 years. Male to female ratio was 1:1. Mean income of the parents was Rs 5780 ± 3194.63.Twenty children (40%) were found to be above cutoff score. There was no significant difference in the behaviour problems between age group 6-12 years and 12-14 years. Sexwise distribution showed no significant difference in behaviour. Mean CBCL score was 40.6 ± 33.90 (Table 2). Eleven children (30.6%) from the armed forces background were above cutoff which was significantly lower than that in civil population (69.4%) ( Table 3). There was no significant difference in behaviour problems between children of officers and the other ranks (Tables 4 & 5). Study of Behaviour Problems in a Paediatric Outpatient DepartmentMaj J Prakash * , Brig S Sudarsanan + , Col PK Pardal # , Col S Chaudhury (Retd) ** Abstract Background : Behaviour problems in children still needs precise definition, explicit criterion and assessment on multiple paradigms. Methods : Fifty children of the age group 6-14 years , from paediatric outpatient department, selected after randomisation were assessed for behaviour problems with the child behaviour checklist. The data collected was analysed using appropriate statistical tests. Results : ...