Atropine is an anticholinergic drug which is used in both parental and topical routes. Topical eye-drops of atropine sulfate are used as mydriatic and cycloplegics. Parental atropine-induced delirium is well known but topical atropine eye-drop-induced delirium cases are very limited in literature. In this case report, an elderly man underwent cataract surgery and developed delirium after the use of 1% atropine sulfate eye-drops as prescribed. This case supports the notion that even atropine eye-drops can cause delirium in patients at therapeutic doses in elderly.

Background: The frequency of radiological investigations increases to many fold now-a-days, so it is necessary to know the knowledge of all physicians about radiation dose, safety measures and regulations which governs the use and practice of radiation examination and their therapeutic use. The objectives comprise to investigate amongst all Physicians: (1) level of knowledge and awareness of radiation dose of radiological investigations and radiobiology of radiation exposure, and (2) to assess physicians’ knowledge about the risks associated with the use of radiological examinations and their safety measures.Methods: A questionnaire targeting about knowledge, safety measures, and radiation biology about some commonly performed radiological procedures was addressed: (1) Relative radiation doses, (2) Associated risks of radiation exposure, (3) What safety measures should be considered before examination. (4) What risk and hazards all physicians considered when requesting radiological examinations.Results: A questionnaire answered by physicians demonstrates loops in knowledge. In all, 15% (14/92) incorrectly believed that magnetic resonance imaging involved radiation exposure and 3% (3/92) incorrectly believed that ultrasound involved radiation exposure; 38% (35/92) stated that they always explain the benefits and risk of radiation to their patients when obtaining informed consent for examinations involving radiation.Conclusions: This study concluded a deficit of knowledge about radiation dose exposure, and hazards among Physicians, which may cause them to request more radiological investigations than appropriate and high-dose investigations instead of lower dose alternatives. Providing better radiation protection training may help improve their basic knowledge on the subject and reduce unnecessary patient exposure to radiation.

Introduction: Previous studies were predominantly on earlyonset schizophrenia with little emphasis on clinical profile, therapeutic responsiveness and various investigational, biochemical and neuroimaging variables in Late-onset Schizophrenia (LOS), which is an emerging concern in elderly morbidity, and differs significantly from Early-onset Schizophrenia (EOS). Aim: To study the clinical profile, and response to various antipsychotic drugs in LOS and compare it with EOS. Materials and Methods: A clinical prospective cohort study was conducted in Shyam Shah Medical College, Rewa Madhya Pradesh, India, from January 2020 to June 2021, with baseline and follow-up assessment of psychotic and cognitive symptoms after four weeks using PANSS (Positive and Negative Syndrome Scale), MoCA (Montreal Cognitive Assessment) and BPRS (Brief Psychiatric Rating Scale) scales. A total of 51 patients were included in the study, divided into two groups of early and late onset, attending the out-patient and in-patient services during the period at the center and concomitant treatment with antipsychotics for four weeks. Statistical analysis was done in Statistical Package for Social Sciences (SPSS) version 21.0 with p-value of 0.05. Results: A total of 51 patients, 27 in EOS group and 24 in LOS were included and analysed in the present study. The demographic profile of late and EOS varied in mean age with EOS at 30.11 years and LOS at 57.66 years), gender distribution predominantly males (n=19) in EOS and predominantly females (n=20) in LOS) and the average age of onset of EOS was 22.05 years and LOS was 55.54 years. The duration of illness in EOS 7.98 years and LOS was 2.12 years. The mean Positive and Negative Syndrome Scale score at baseline for EOS was 1.92±1.07 and LOS was 2.83±0.56 and four weeks for EOS was 1.70±0.91 and LOS was 2.83±0.56. The response in Positive and Negative Syndrome Scale at 4 weeks as well as individual domain scale score such as hallucinations, suspiciousness, blunted effect, emotional withdrawal, active social avoidance showed significant results in both EOS and LOS. Conclusion: Schizophrenia can manifest for the first time in late life and manifestations of stringently defined schizophrenia is by no means confined to onset at younger ages. Although there are undoubted similarities between the symptoms of EOS and LOS, there are also clear differences, especially demographic and clinical characteristics, early identification of which will help in adequate intervention and prevention of further morbidity in the elderly.

Introduction: Mortality rates in schizophrenia patients due to cardiovascular events are reported to be more than the general population. Dyslipidaemia, obesity, diabetes, and hypertension are some of the common illnesses these patients are vulnerable to develop. The drugs which are used to treat schizophrenia and other related disorders i.e. antipsychotics causes increase in weight, dyslipidaemia and insulin resistance in some patients. Some agent’s i.e. Second Generation Antipsychotics (SGA) cause more of the above mentioned symptoms and than others agent’s i.e. First Generation Antipsychotics (FGA). The novelty of the study includes the emergence of Metabolic syndrome (MetS) in drug naïve or drug free patients who were prescribed trifluoperazine and olanzapine and comparative study of them. Aim: To assess the emergence of MetS in drug naïve patients of schizophrenia after the administration of trifluoperazine-FGA and olanzapine-SGA. Materials and Methods: A cohort study was conducted from May 2019 to March 2021, in the Department of Psychiatry, Shyam Shah Medical College, and Rewa, Madhya Pradesh, India. Study was started after the clearance from institutional ethical committee. The study included 41 drug naïve indoor and outdoor patients, diagnosed as schizophrenia according to International Classification of Diseases 10 Diagnostic Criteria for Research (ICD 10 DCR). The patients were divided into two groups, one group was prescribed FGA trifluoperazine and other was prescribed SGA olanzapine. Twenty patients were prescribed olanzapine and 21 patient’s trifluoperazine. Metabolic parameters were taken before onset of drug treatment therapy, after two and four months respectively. The patients were given medications for four months. The changes in metabolic parameters i.e., waist circumference, blood pressure, Fasting Blood Sugar (FBS), triglycerides, and Low HDL (High Density Lipoprotein) were compared using unpaired student’s t-test and repeated measure Analysis of Variance (ANOVA) with p-value <0.05 considered as significant. Results: It was found that out of total 41 patient, 4 patients (19.4%) and 12 patients (60%) patients prescribed trifluoperazine and olanzapine respectively developed Mets after four months of antipsychotic medication. Also, there was a significant change in various parameters of MetS in both groups as seen in repeated measure ANOVA. Conclusion: SGA cause significantly more changes in the metabolic parameters and compared to the FGA, increasing the likelihood of developing MetS and associated disorders like cerebrovascular accidents and diabetes mellitus type-II.

Background: A cancer diagnosis can have a significant impact on mental health and wellbeing. Cancer is the second most common cause of death after heart diseases and it accounted for 9.6 million deaths worldwide in 2018. Various individual psychosocial and contextual factors potentially contribute to the development of anxiety and depression among people with cancer. In comparison with general people, the prevalence of anxiety and depression is frequently found to be higher among cancer patient, but estimates vary due to various factors, such as the type of cancer, treatment setting, and prognosis of disease. The present study was conducted to find out the estimate of depression in cancer patients undergoing chemotherapy and determine the various factors associated with depression.Methods: A cross-sectional study was conducted amongst cancer patients undergoing chemotherapy at Department of Oncology, Government Bundelkhand Medical College and Hospital, Sagar from January to April 2019. 150 participants were interviewed using predesigned questionnaire based on the Beck’s depression inventory.Results: Out of 150 cancer patients, 83 (55.3%) were found to be depressed. Depression was comparatively higher in patients’ ≥50 years; in males. Among the study patients, 83 (55.33%) had depression of which 21 (25.3%) had borderline clinical depression, 54 (65.06%) had moderate depression and 08 (9.6%) had severe depression.Conclusions: The study revealed depression in majority of patients receiving chemotherapy. Treatment of cancer patients need to be complemented by psychological support. Research is urgently needed into the possible impacts of long term effects of cancer treatment on mental health.