Background: Emergence of atypical antipsychotics has revolutionized the treatment of schizophrenia by exploiting dual actions on serotonin as well as dopaminergic receptors. Still, monotherapy with these agents is insufficient to control cognitive and psychomotor as well as positive and negative symptoms. Hence combination therapy with antipsychotics is common in clinical practice. Objective of current study is to compare the effects of addition of aripiprazole or paliperidone on cognition and psychomotor functions in schizophrenia receiving olanzapine. Methods: This is prospective, double blind, placebo controlled, parallel group study in 90 patients of schizophrenia showing partial or no response to olanzapine measured by Positive And Negative Symptoms Score (PANSS) scale. They were randomly divided to receive adjuvant aripiprazole, paliperidone or placebo for 6 weeks. Results: Combination of aripiprazole and olanzapine shows significant improvement in most of the cognition and psychomotor parameters like attention, perception, verbal memory, thinking and processing as well as motor speed while combination of paliperidone and olanzapine is associated with improvement in only some of the cognitive and psychomotor parameters such as attention, perception and verbal memory only. Both the combinations are efficacious in controlling positive and negative symptoms of schizophrenia as assessed by PANSS scale. Conclusions: The best augmenting strategy with for olanzapine nonresponsive patients will be D 2 receptor partial agonist like aripiprazole rather than D 2 antagonist like paliperidone and other atypical antipsychotic agents for better improvement in cognition and psychomotor domains.

Background: Usage of smart phones is on the rise not top exclude medical students. Stress among medical students is also known due to various reasons. A study to assess addiction to smart phones in medical students and its relation to the perceived stress in them was planned in a tertiary care hospital in central India. There are 2 aims-1) To study hours of phone and social media use and smart phone addiction in medical students 2) To study the levels of perceived stress in them and its relation to the levels of smart phone addiction Methods: Medical students willing to participate in the study and those having android phones were explained the nature of research study and were enrolled after written and informed consent. They were asked to install a free application called app usage tracker from play store so as to track their phone usage. Confidentiality of personal information d data was ensured and informed to participants of the study. Data was collected at end of 7 days. Stress was assessed using perceived stress scale and addiction assessed using smart phone addiction scale. Data was tabulated and analysed using SPSS 17. Results: 52 males (51.5%) males and 48 (48.5%) females participated in the study. Mean age of students 19.4 years (range 17-26)88.1 % were single while others in a relationship. 56.4% stayed in hostels while others in their family. All of them used android phones. The average use of smart phone was 6.5 hours/ day (range 1-14 hours) as calculated by the phone application. Mean score on students on smart phone addiction scale was 36.16 (range 11-60, mean Cut off being 20, indicating most of the participants were addicted to their smart phones. Mean score on the perceived stress scale was 20.73 indicating that the study participants had moderate levels of stress (14-26). The correlation between smart phone addiction and the perceived stress in students was positive and significant. Conclusion: The addiction is thus a matter of concern for medical students and their future. It is also pertinent to note that, as the study points out, that medical students are continuously under a moderate level stress. Stressed individuals trying to find solace in their phones are again more vulnerable and at more risk of developing mental illnesses like insomnias, anxiety, depression, substance dependence etc.