Calcification of basal ganglia or Fahr's syndrome is a rare disease characterized by bilateral and symmetrical intracranial deposition of calcium mainly in cerebral basal ganglia. Motor and neuropsychiatric symptoms are prominent features. We report a case presented with a few motor symptoms, features of delirium and prominent psychiatric symptoms (disorganized behavior) predominantly evident after the improvement in delirium. Radiological findings were suggestive of bilateral basal ganglia calcification. Parathyroid hormone levels were low with no significant findings in other investigations and negative family history. Patient showed significant improvement in behavioral disturbances with risperidone, low dose of lorazepam, oxcarbazepine, and memantine.

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Objective: Patients admitted to the medical intensive care unit (MICU) for various medical morbidities are prone to suffer various psychiatric symptoms. Common conditions for which psychiatric consultation is sought are anxiety, delirium, self-harm attempt, and adjustment disorder. Anxiety is a commonly encountered problem and can affect the treatment outcome and compliance. This study was carried out in the MICU of tertiary care hospital to assess the pattern of anxiety symptoms in patients admitted to the MICU. Material and Methods: Sixty patients admitted to MICU were included in the study and assessed using semi-structured pro forma, Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale, and Faces Anxiety Scale. Data were statistically analyzed using mean, Chi-square test, t-test, and logistic regression test. Results: The majority of the participants were male, predominantly belonging to the age group of 40–59 years. Most of them had some physical, behavioral, or psychological symptoms of anxiety in a mild form. Although the extent of the anxiety symptoms in most of the patients was mild, a few also reported a moderate level of anxiety. Patients with cardiac and respiratory disorders had higher scores on anxiety rating scales than those with other diagnoses. Male gender, cardiorespiratory disease, and the presence or absence of anxiety had a negative correlation (r = −1.79) whereas gender, disease, and presence of mild or moderate anxiety had no statistical significance. Conclusion: Most of the patients, especially those admitted with cardiac and respiratory disorders, had mild anxiety symptoms. Assessment of anxiety in MICU patients can be an important aspect to prevent or reduce the overall disease burden.

Background: In developing world, the number of women undergoing miscarriage has increased. Women facing miscarriage are susceptible to develop depression and the risk is more if the perceived social support is low or not adequate. This study was conducted to assess the presence of depressive features and perceived social support and to correlate between the two entities in patients with miscarriage. Methods: This was a cross-sectional, single interview study conducted in 100 consecutive patients with miscarriage in current pregnancy admitted in obstetrics and gynecology ward of a tertiary care center. After ethics committee approval and written informed consent, each patient was individually interviewed using a semi structured proforma. To assess depressive features, Patient Health Questionnaire-9 (PHQ-9) and to evaluate perceived social support-Multidimensional Scale for Perceived Social Support (MSPSS) were administered. Data was analyzed statistically. Results: The mean age of the participant was 28.5 years (3.9), all of them were married, majority of them being housewives, with primary/secondary level of education and from rural area. On assessment with PHQ9, the prevalence of depression was 32%. Among them 17 % had mild depression, 12% had moderate depression, and 3% had severe depression. Women with advancing age, lower education level, unemployment, previous miscarriage, miscarriage following treatment for infertility had significant depression. The perceived social support in the form of family and friends was significantly less in depressed patients. Conclusion: Miscarriage is a significant stressful event in a women's life. These women should be evaluated for depressive symptoms and carers should be psycho-educated regarding need of social support following miscarriage. Early diagnosis and management of depression will help in reducing further morbidity and will improve the quality of life of these patients.

Background. Anxiety and panic are known to be associated with bronchial asthma with variety of impact on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. This study aims to explore the pattern of panic symptoms, prevalence and severity of panic disorder (PD), quality of life, and disability in them. Methods. Sixty consecutive patients of bronchial asthma were interviewed using semistructured proforma, Panic and Agoraphobia scale, WHO Quality of life (QOL) BREF scale, and WHO disability schedule II (WHODAS II). Results. Though 60% of the participants had panic symptoms, only 46.7% had diagnosable panic attacks according to DSM IV TR diagnostic criteria and 33.3% had PD. Most common symptoms were “sensations of shortness of breath or smothering,” “feeling of choking,” and “fear of dying” found in 83.3% of the participants. 73.3% of the participants had poor quality of life which was most impaired in physical and environmental domains. 55% of the participants had disability score more than a mean (18.1). Conclusion. One-third of the participants had panic disorder with significant effect on physical and environmental domains of quality of life. Patients with more severe PD and bronchial asthma had more disability.