Dr Pramod Thomas - Academia.edu (original) (raw)
Papers by Dr Pramod Thomas
Tropical Doctor, Feb 7, 2022
In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop i... more In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop in platelet count has serious connotations, and is frequently evidenced by a palatal rash.
Psychiatry Research-neuroimaging, Dec 1, 2008
Olanzapine is widely used for the treatment of schizophrenia and is considered a first line medic... more Olanzapine is widely used for the treatment of schizophrenia and is considered a first line medication in India. Along with other factors, the variation in response and side effects to this agent may be accounted for by genetic differences among patients. Olanzapine was administered for 6 weeks to Indian subjects with schizophrenia or schizoaffective disorder (DSM-IV, n = 130), as part of an open label study. Intent-to-treat analysis was performed, and 10 polymorphic markers from seven genes (dopamine D1, D2, D3 and D4 receptors, serotonin 2A receptor and the drug-metabolizing enzymes (CYP1A2 and CYP2D6)), together with demographic and clinical variables, were analyzed as potential predictors of response. Olanzapine was efficacious, but significant weight gain was noted. Baseline weight and a 120 bp deletion polymorphism at the dopamine receptor D4 (DRD4) gene were associated with changes in symptom scores. Predictable covariates of treatment response were also noted. These results merit replicate studies.
International journal of reproduction, contraception, obstetrics and gynecology, Oct 23, 2019
Abnormal uterine bleeding (AUB) is one of the most common problem encountered in gynaecology clin... more Abnormal uterine bleeding (AUB) is one of the most common problem encountered in gynaecology clinics causing huge impact on women's quality of life with a reported incidence of 14% to 25% among women of reproductive age group. 1 Descriptive terms used to categorise AUB pattern include heavy menstrual bleeding, intermenstrual bleeding, post-menopausal bleeding, polymenorrhea and irregular bleeding pattern. According to PLAM-COIEN classification of AUB introduced by FIGO the aetiology of AUB is classified into structural and non-structural causes. ACOG recommends endometrial biopsy for women with AUB older than 45 year as first line test and in younger women with history of unopposed oestrogen exposure (such as obesity, and PCOS), failed medical management and persistent AUB. 2 Sampling of endometrium can be done ABSTRACT Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability. Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology. Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report. Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.
![Research paper thumbnail of Endoscopic Dacryocystorhinostomy [DCR] with Merocel Pack in the Lacrimal Sac- an Innovative Technique](https://attachments.academia-assets.com/111600980/thumbnails/1.jpg)
](Journal of evolution of medical and dental sciences, Sep 3, 2018
BACKGROUND DCR is a surgical procedure performed to create a new tear drainage pathway between th... more BACKGROUND DCR is a surgical procedure performed to create a new tear drainage pathway between the eye and the nose when the tear drain becomes obstructed at the level of nasolacrimal duct, which is the commonest site of blockage in lacrimal apparatus. This technique of DCR with Merocel pack in the lacrimal sac completely avoids any complications like lacrimal pump failure, canthal erosion, canthal cheese wiring, although few patients exhibit complications like granuloma, synechiae/ adhesions and foreign body sensation inside the nose for few days. Patients are relieved of epiphora/ mucocele with less operative time and post-operative care. The objective of the study is to describe the various complications, which can occur in endoscopic DCR procedure. MATERIALS AND METHODS It is a descriptive study. We enrolled 30 participants with nasolacrimal duct obstruction presenting with epiphora, mucocele and palpable lacrimal sac and were managed with endoscopic DCR with a 'Merocel pack in the sac technique.' The present study was conducted at the Ministry of Health Hospital, Rustaq, Sultanate of Oman, during 2007 to 2014. The sample size was taken for convenience during the study. RESULTS Results were compared with standard external DCR and endoscopic DCR with silicone stents. All patients were operated under general anaesthesia. Participants were followed for 6 months and outcomes (Absence of epiphora and the patency of sac) and complications (lacrimal pump failure, canthal erosion, canthal cheese wiring granuloma, synechiae/ adhesion and foreign body sensation) were measured. Lacrimal sac was opened and the Merocel pack was kept in the sac (1 cm x 0.5 cm) for 10 days and then removed. The present innovative technique gave good results (p-value < 0.0001), took less post-operative time and fewer postoperative complications. CONCLUSION Endoscopic DCR with 'Merocel pack in the sac technique' is an excellent novel technique for the treatment of epiphora and mucocele due to nasolacrimal duct obstruction. It should be the treatment of choice in view of maintenance of long-term results, patient compliance and cost effectiveness.
Indian Journal of Psychological Medicine, Sep 1, 2016
Aim: To examine the prevalence and pattern of comorbidity in alcohol dependence and its relations... more Aim: To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings. Materials and Methods: Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10 th Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram. Results: Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity. Conclusions: High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.
International Surgery Journal, Jan 29, 2022
Urinary tract infections (UTIs) are common bacterial infections affecting the population, across ... more Urinary tract infections (UTIs) are common bacterial infections affecting the population, across age and gender. Around 50-60% of women will develop UTIs in their lifetimes. 1 Almost one-third of all women before the age of 24 would have had at least one episode of UTI which required antibiotic treatment. 2 Studies have found significant medical and financial implications associated with UTIs. Acute uncomplicated UTI among young adults may be benign. However it can be associated with impaired renal function and end-stage renal disease among paediatric patients. 2 A web-based survey on adult women in Europe found approximately 50% of women experienced uncomplicated UTI and 20-30 % experienced recurrent UTI, significantly affecting the quality of life. Antibiotic use and absence from work were the factors impacting quality of life. Recurrence was common in spite of prophylactic measures. 3 The incidence of UTI is particularly higher during adolescence, a period during which there is a complex interplay of biological, psychological, and social factors. 4
Psychiatry Investigation, 2010
ObjectiveaaTo test the hypothesis that similar differences in psychopathology are present across ... more ObjectiveaaTo test the hypothesis that similar differences in psychopathology are present across cultures among men and women with schizophrenia (SZ). MethodsaaSex based differences were tested systematically in two independent samples from the Northeastern USA and North India using the same procedures. The clinical variables were obtained from five interview instruments. ResultsaaAmong the US participants, the number of significant differences exceeded chance predictions (15/240 variables significant at p<0.02, 6.25%; expected number of significant differences: 5). Similarly, a greater than expected number of variables differed significantly between men and women among the Indian subjects (13/230 differences at p<0.02, 5.65%; expected: 5). One of these variables significantly differed in both samples (lifetime abuse of cannabis). When multivariate analyses were conducted in the combined US and Indian samples sex based differences remained for only four variables: course of the illness, history of inappropriate emotions, marital status and number of children. ConclusionaaSex based differences in SZ/schizoaffective disorder are present in the USA and India at greater than chance probabilities. The majority of the variables differ across the samples. The biological underpinnings of these variables need further investigation.
Indian Journal of Community Medicine, 2023
There has been extensive interest in sex differences in schizophrenia (SZ). The research runs the... more There has been extensive interest in sex differences in schizophrenia (SZ). The research runs the gamut from large scale epidemiological studies to smaller studies describing diagnostic and clinical differences. Some studies, including meta-analyses, suggest a modest increase in the incidence and prevalence of SZ among men. 1-3 More substantive differences in clinical features, particularly severity have been documented repeatedly. Women with SZ report affective symptoms, auditory hallucinations and persecutory delusions more frequently, with lower prevalence of smoking and substance abuse. 4 These authors also reported that male patients had more negative symptoms and cognitive deficits. Though a prospective, double blind placebo controlled trial comparing 24 male and 20 female patients did not find significant sex-based differences, 5 an extensive review suggested that optimal antipsychotic maintenance regimens differ between women and men. 6 A review of 76 studies on tardive dysk...
Indian Journal of Community Medicine
Sri Lanka Journal of Child Health
Schizophrenia Research, 2007
Introduction: Demographic, clinical and familial factors may plausibly influence the manifestatio... more Introduction: Demographic, clinical and familial factors may plausibly influence the manifestation of hallucinations. It is unclear if the pattern of the effects is similar in different environmental/cultural settings. Aims: To evaluate factors associated with hallucination from a demographic, clinical and familial perspective in two distinct cultural settings. Methods: Patients with a clinical diagnosis of schizophrenia (SZ) or schizoaffective disorder (SZA) were diagnosed systematically using DSM IV criteria. Two independent samples were recruited in India and USA using identical inclusion/exclusion criteria and assessment procedures (n = 1287 patients total; 807 Indian and 480 US participants). The association of key demographic and clinical factors with hallucinations of different modalities was examined. To evaluate the impact of familial factors, we separately analyzed correlations among affected sibling pairs (ASPs, n = 136, Indian; n = 77, US). Results: The prevalence of different modalities of hallucinations differed in the Indian and US samples, though the rank order of frequency was similar. The pattern of associations between selected variables and the risk of hallucinations was different across cultures, except for some correlations with indices of severity. No significant concordance was observed among the ASPs after correcting for multiple comparisons. Conclusions: The factors associated with hallucinations vary across environments. Our results are consistent with a multi-factorial etiology of psychopathology, but redirect attention to endophenotypic features in the causal chain that precede the symptoms themselves.
British Journal of Psychiatry, 1994
Darier's disease is a rare autosomal dominantly inherited keratosis. This is an account of on... more Darier's disease is a rare autosomal dominantly inherited keratosis. This is an account of one family in which there is co-occurrence of major affective disorder and Darier's disease in five members and absence of both disorders in five members. The pedigree is consistent with genetic linkage between the Darier gene and a major autosomal dominant susceptibility locus for major affective disorder. When the Darier's disease gene has been mapped, its chromosomal location will be an interesting candidate locus for linkage studies of major affective disorder.
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 2010
contributed equally to this work. CONFLICTS OF INTEREST David A. Lewis currently receives investi... more contributed equally to this work. CONFLICTS OF INTEREST David A. Lewis currently receives investigator-initiated research support from the BMS Foundation, Bristol-Myers Squibb, Curridium Ltd and Pfizer and in 2007-2009 served as a consultant in the areas of target identification and validation and new compound development to AstraZeneca, Bristol
Tropical Doctor, 2022
In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop i... more In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop in platelet count has serious connotations, and is frequently evidenced by a palatal rash.
International Surgery Journal, 2022
Background: Urinary tract infection (UTI) is a common reason for accessing health care services i... more Background: Urinary tract infection (UTI) is a common reason for accessing health care services in all age groups. Women are more susceptible to UTI across age groups. Among males, the prevalence decreases in adolescence. Socio-economic and behavioural factors may play a significant role in the higher prevalence of UTI among adolescent girls. A study on UTI among children and adolescents will give a better insight in to the gravity of the problem and suggest appropriate interventions. Aim of the current study was to investigate the prevalence of urinary tract infection in males and females in the age group 0 to 20 based on the urine routine examination.Methods: This retrospective study included patients who had urine routine examination (URE) done based on clinical symptoms, during the period from January to December 2018 in a tertiary care teaching hospital. Data was obtained from the laboratory records and medical records department.Results: 1574 (3.43%) out of 45896 patients had ...
Indian Journal of Clinical and Experimental Ophthalmology, 2021
Blindness, loss of eyesight, could be temporary or permanent. Damage to any portion of the eye, o... more Blindness, loss of eyesight, could be temporary or permanent. Damage to any portion of the eye, optic nerve or the brain that is responsible for this function results in visual impairment. The commonest causes for blindness are cataract, refractive errors, glaucoma, corneal opacities. Assess major causes of visual impairment among new patients visiting ophthalmology OPD. : Study conducted using a cross sectional survey design. Data collected from ophthalmology OPD of a tertiary care hospital.The proportion of ocular diseases, degree of blindness and causative factors were assessed and recorded. Patient’s visual impairment status was classified as mild, moderate, severe and blind according to WHO classification for visual impairment and blindness (Oct. 2019). Visual acuity, auto refraction, colour vision, intra ocular pressure measurement, slit lamp and fundus examinations were carried out. Data Entry: MS Excel. Statistics: chi square, proportions. There were 303 participants, 42.2% ...
Asian Journal of Medical Sciences, 2021
Background: Scrub typhus (ST) is a common Rickettsial infection which has been increasingly repor... more Background: Scrub typhus (ST) is a common Rickettsial infection which has been increasingly reported from the various states of southern part of India. Aims and Objective: With very few reports from Central Kerala, we aimed to study the seroprevalence of scrub typhus and its clinical profile. Materials and Methods: Patients presenting with acute undifferentiated febrile illness and other symptoms and signs of Rickettsial infections during a period of two years were included in this prospective study. Serodiagnosis of ST was based on a positive Scrub typhus IgM Enzyme Linked Immunosorbent Assay (ELISA) and/or agglutination for OXK in Weil Felix test. The cut-off for ELISA was calculated. The clinical and laboratory details of the positive patients were obtained and bivariate analysis was performed. Results: The cut-off for ST IgM ELISA was calculated and found to be 0.38. Of the 636 samples screened, 34 (5.3%) were positive for ST IgM ELISA. Out of the 34 positive samples, only 5 (0....
Tropical Doctor, Feb 7, 2022
In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop i... more In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop in platelet count has serious connotations, and is frequently evidenced by a palatal rash.
Psychiatry Research-neuroimaging, Dec 1, 2008
Olanzapine is widely used for the treatment of schizophrenia and is considered a first line medic... more Olanzapine is widely used for the treatment of schizophrenia and is considered a first line medication in India. Along with other factors, the variation in response and side effects to this agent may be accounted for by genetic differences among patients. Olanzapine was administered for 6 weeks to Indian subjects with schizophrenia or schizoaffective disorder (DSM-IV, n = 130), as part of an open label study. Intent-to-treat analysis was performed, and 10 polymorphic markers from seven genes (dopamine D1, D2, D3 and D4 receptors, serotonin 2A receptor and the drug-metabolizing enzymes (CYP1A2 and CYP2D6)), together with demographic and clinical variables, were analyzed as potential predictors of response. Olanzapine was efficacious, but significant weight gain was noted. Baseline weight and a 120 bp deletion polymorphism at the dopamine receptor D4 (DRD4) gene were associated with changes in symptom scores. Predictable covariates of treatment response were also noted. These results merit replicate studies.
International journal of reproduction, contraception, obstetrics and gynecology, Oct 23, 2019
Abnormal uterine bleeding (AUB) is one of the most common problem encountered in gynaecology clin... more Abnormal uterine bleeding (AUB) is one of the most common problem encountered in gynaecology clinics causing huge impact on women's quality of life with a reported incidence of 14% to 25% among women of reproductive age group. 1 Descriptive terms used to categorise AUB pattern include heavy menstrual bleeding, intermenstrual bleeding, post-menopausal bleeding, polymenorrhea and irregular bleeding pattern. According to PLAM-COIEN classification of AUB introduced by FIGO the aetiology of AUB is classified into structural and non-structural causes. ACOG recommends endometrial biopsy for women with AUB older than 45 year as first line test and in younger women with history of unopposed oestrogen exposure (such as obesity, and PCOS), failed medical management and persistent AUB. 2 Sampling of endometrium can be done ABSTRACT Background: Abnormal uterine bleeding is one of the most common problem encountered in gynaecology clinics. Assessment of endometrial pathology is recommended to rule out malignancy and premalignant conditions. Endometrial sampling can be done by Pipelle biopsy in outpatient units as well as by conventional dilatation and curettage in an operation theatre setup. Our study aims to find out the efficacy of office endometrial biopsy in terms of its sample adequacy, diagnostic accuracy and patient acceptability. Methods: 120 women presenting with abnormal uterine bleeding were included. A detailed history along with clinical examination findings are entered in the proforma. Ultrasound scan was done for all of them to identify pelvic pathology and endometrial thickness. Endometrial sampling was then done with Pipelle without anaesthesia. Histopathology reports are collected and sample adequacy and pattern were analysed. Patients are subsequently followed up for a period up to one year. Those who underwent hysterectomy are analysed for the endometrial pathology in hysterectomy specimen which is used as gold standard and compared with Pipelle endometrial sampling histopathology. Results: Sample adequacy for Pipelle biopsy was found to be 96%. Diagnostic accuracy for atypical hyperplasia and adenocarcinoma is 92.5% and 94% respectively. In hysterectomy specimens, carcinoma endometrium coexisted with atypical hyperplasia in 40% of cases with atypical hyperplasia in pipelle biopsy report. Conclusions: Thus, Pipelle endometrial biopsy is a cost-effective method for endometrial sampling except for focal lesions.
Journal of evolution of medical and dental sciences, Sep 3, 2018
BACKGROUND DCR is a surgical procedure performed to create a new tear drainage pathway between th... more BACKGROUND DCR is a surgical procedure performed to create a new tear drainage pathway between the eye and the nose when the tear drain becomes obstructed at the level of nasolacrimal duct, which is the commonest site of blockage in lacrimal apparatus. This technique of DCR with Merocel pack in the lacrimal sac completely avoids any complications like lacrimal pump failure, canthal erosion, canthal cheese wiring, although few patients exhibit complications like granuloma, synechiae/ adhesions and foreign body sensation inside the nose for few days. Patients are relieved of epiphora/ mucocele with less operative time and post-operative care. The objective of the study is to describe the various complications, which can occur in endoscopic DCR procedure. MATERIALS AND METHODS It is a descriptive study. We enrolled 30 participants with nasolacrimal duct obstruction presenting with epiphora, mucocele and palpable lacrimal sac and were managed with endoscopic DCR with a 'Merocel pack in the sac technique.' The present study was conducted at the Ministry of Health Hospital, Rustaq, Sultanate of Oman, during 2007 to 2014. The sample size was taken for convenience during the study. RESULTS Results were compared with standard external DCR and endoscopic DCR with silicone stents. All patients were operated under general anaesthesia. Participants were followed for 6 months and outcomes (Absence of epiphora and the patency of sac) and complications (lacrimal pump failure, canthal erosion, canthal cheese wiring granuloma, synechiae/ adhesion and foreign body sensation) were measured. Lacrimal sac was opened and the Merocel pack was kept in the sac (1 cm x 0.5 cm) for 10 days and then removed. The present innovative technique gave good results (p-value < 0.0001), took less post-operative time and fewer postoperative complications. CONCLUSION Endoscopic DCR with 'Merocel pack in the sac technique' is an excellent novel technique for the treatment of epiphora and mucocele due to nasolacrimal duct obstruction. It should be the treatment of choice in view of maintenance of long-term results, patient compliance and cost effectiveness.
Indian Journal of Psychological Medicine, Sep 1, 2016
Aim: To examine the prevalence and pattern of comorbidity in alcohol dependence and its relations... more Aim: To examine the prevalence and pattern of comorbidity in alcohol dependence and its relationship with physical and laboratory findings. Materials and Methods: Eighty males with alcohol dependence were examined using the Hindi version of Diagnostic Interview for Genetic Studies, the International Classification of Disease-10 th Edition Personality Disorder Examination, Alcohol Use Disorder Identification Test for alcohol use, global assessment of functioning, blood sampling electrocardiogram, and ultrasonogram. Results: Eighty-seven percent had a comorbid Axis I or an Axis II psychiatric disorder, over 78% had nicotine dependence, and 56% had comorbid Axis II disorder, antisocial personality being the most common. Gamma glutamyl transpeptidase levels were significantly associated with comorbidity. Conclusions: High comorbidity of Axis I psychiatric disorders was found among persons with alcohol dependence. Axis II disorders were also present.
International Surgery Journal, Jan 29, 2022
Urinary tract infections (UTIs) are common bacterial infections affecting the population, across ... more Urinary tract infections (UTIs) are common bacterial infections affecting the population, across age and gender. Around 50-60% of women will develop UTIs in their lifetimes. 1 Almost one-third of all women before the age of 24 would have had at least one episode of UTI which required antibiotic treatment. 2 Studies have found significant medical and financial implications associated with UTIs. Acute uncomplicated UTI among young adults may be benign. However it can be associated with impaired renal function and end-stage renal disease among paediatric patients. 2 A web-based survey on adult women in Europe found approximately 50% of women experienced uncomplicated UTI and 20-30 % experienced recurrent UTI, significantly affecting the quality of life. Antibiotic use and absence from work were the factors impacting quality of life. Recurrence was common in spite of prophylactic measures. 3 The incidence of UTI is particularly higher during adolescence, a period during which there is a complex interplay of biological, psychological, and social factors. 4
Psychiatry Investigation, 2010
ObjectiveaaTo test the hypothesis that similar differences in psychopathology are present across ... more ObjectiveaaTo test the hypothesis that similar differences in psychopathology are present across cultures among men and women with schizophrenia (SZ). MethodsaaSex based differences were tested systematically in two independent samples from the Northeastern USA and North India using the same procedures. The clinical variables were obtained from five interview instruments. ResultsaaAmong the US participants, the number of significant differences exceeded chance predictions (15/240 variables significant at p<0.02, 6.25%; expected number of significant differences: 5). Similarly, a greater than expected number of variables differed significantly between men and women among the Indian subjects (13/230 differences at p<0.02, 5.65%; expected: 5). One of these variables significantly differed in both samples (lifetime abuse of cannabis). When multivariate analyses were conducted in the combined US and Indian samples sex based differences remained for only four variables: course of the illness, history of inappropriate emotions, marital status and number of children. ConclusionaaSex based differences in SZ/schizoaffective disorder are present in the USA and India at greater than chance probabilities. The majority of the variables differ across the samples. The biological underpinnings of these variables need further investigation.
Indian Journal of Community Medicine, 2023
There has been extensive interest in sex differences in schizophrenia (SZ). The research runs the... more There has been extensive interest in sex differences in schizophrenia (SZ). The research runs the gamut from large scale epidemiological studies to smaller studies describing diagnostic and clinical differences. Some studies, including meta-analyses, suggest a modest increase in the incidence and prevalence of SZ among men. 1-3 More substantive differences in clinical features, particularly severity have been documented repeatedly. Women with SZ report affective symptoms, auditory hallucinations and persecutory delusions more frequently, with lower prevalence of smoking and substance abuse. 4 These authors also reported that male patients had more negative symptoms and cognitive deficits. Though a prospective, double blind placebo controlled trial comparing 24 male and 20 female patients did not find significant sex-based differences, 5 an extensive review suggested that optimal antipsychotic maintenance regimens differ between women and men. 6 A review of 76 studies on tardive dysk...
Indian Journal of Community Medicine
Sri Lanka Journal of Child Health
Schizophrenia Research, 2007
Introduction: Demographic, clinical and familial factors may plausibly influence the manifestatio... more Introduction: Demographic, clinical and familial factors may plausibly influence the manifestation of hallucinations. It is unclear if the pattern of the effects is similar in different environmental/cultural settings. Aims: To evaluate factors associated with hallucination from a demographic, clinical and familial perspective in two distinct cultural settings. Methods: Patients with a clinical diagnosis of schizophrenia (SZ) or schizoaffective disorder (SZA) were diagnosed systematically using DSM IV criteria. Two independent samples were recruited in India and USA using identical inclusion/exclusion criteria and assessment procedures (n = 1287 patients total; 807 Indian and 480 US participants). The association of key demographic and clinical factors with hallucinations of different modalities was examined. To evaluate the impact of familial factors, we separately analyzed correlations among affected sibling pairs (ASPs, n = 136, Indian; n = 77, US). Results: The prevalence of different modalities of hallucinations differed in the Indian and US samples, though the rank order of frequency was similar. The pattern of associations between selected variables and the risk of hallucinations was different across cultures, except for some correlations with indices of severity. No significant concordance was observed among the ASPs after correcting for multiple comparisons. Conclusions: The factors associated with hallucinations vary across environments. Our results are consistent with a multi-factorial etiology of psychopathology, but redirect attention to endophenotypic features in the causal chain that precede the symptoms themselves.
British Journal of Psychiatry, 1994
Darier's disease is a rare autosomal dominantly inherited keratosis. This is an account of on... more Darier's disease is a rare autosomal dominantly inherited keratosis. This is an account of one family in which there is co-occurrence of major affective disorder and Darier's disease in five members and absence of both disorders in five members. The pedigree is consistent with genetic linkage between the Darier gene and a major autosomal dominant susceptibility locus for major affective disorder. When the Darier's disease gene has been mapped, its chromosomal location will be an interesting candidate locus for linkage studies of major affective disorder.
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 2010
contributed equally to this work. CONFLICTS OF INTEREST David A. Lewis currently receives investi... more contributed equally to this work. CONFLICTS OF INTEREST David A. Lewis currently receives investigator-initiated research support from the BMS Foundation, Bristol-Myers Squibb, Curridium Ltd and Pfizer and in 2007-2009 served as a consultant in the areas of target identification and validation and new compound development to AstraZeneca, Bristol
Tropical Doctor, 2022
In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop i... more In dengue, which is an arthropod borne illness increasing in prevalence in India, a sudden drop in platelet count has serious connotations, and is frequently evidenced by a palatal rash.
International Surgery Journal, 2022
Background: Urinary tract infection (UTI) is a common reason for accessing health care services i... more Background: Urinary tract infection (UTI) is a common reason for accessing health care services in all age groups. Women are more susceptible to UTI across age groups. Among males, the prevalence decreases in adolescence. Socio-economic and behavioural factors may play a significant role in the higher prevalence of UTI among adolescent girls. A study on UTI among children and adolescents will give a better insight in to the gravity of the problem and suggest appropriate interventions. Aim of the current study was to investigate the prevalence of urinary tract infection in males and females in the age group 0 to 20 based on the urine routine examination.Methods: This retrospective study included patients who had urine routine examination (URE) done based on clinical symptoms, during the period from January to December 2018 in a tertiary care teaching hospital. Data was obtained from the laboratory records and medical records department.Results: 1574 (3.43%) out of 45896 patients had ...
Indian Journal of Clinical and Experimental Ophthalmology, 2021
Blindness, loss of eyesight, could be temporary or permanent. Damage to any portion of the eye, o... more Blindness, loss of eyesight, could be temporary or permanent. Damage to any portion of the eye, optic nerve or the brain that is responsible for this function results in visual impairment. The commonest causes for blindness are cataract, refractive errors, glaucoma, corneal opacities. Assess major causes of visual impairment among new patients visiting ophthalmology OPD. : Study conducted using a cross sectional survey design. Data collected from ophthalmology OPD of a tertiary care hospital.The proportion of ocular diseases, degree of blindness and causative factors were assessed and recorded. Patient’s visual impairment status was classified as mild, moderate, severe and blind according to WHO classification for visual impairment and blindness (Oct. 2019). Visual acuity, auto refraction, colour vision, intra ocular pressure measurement, slit lamp and fundus examinations were carried out. Data Entry: MS Excel. Statistics: chi square, proportions. There were 303 participants, 42.2% ...
Asian Journal of Medical Sciences, 2021
Background: Scrub typhus (ST) is a common Rickettsial infection which has been increasingly repor... more Background: Scrub typhus (ST) is a common Rickettsial infection which has been increasingly reported from the various states of southern part of India. Aims and Objective: With very few reports from Central Kerala, we aimed to study the seroprevalence of scrub typhus and its clinical profile. Materials and Methods: Patients presenting with acute undifferentiated febrile illness and other symptoms and signs of Rickettsial infections during a period of two years were included in this prospective study. Serodiagnosis of ST was based on a positive Scrub typhus IgM Enzyme Linked Immunosorbent Assay (ELISA) and/or agglutination for OXK in Weil Felix test. The cut-off for ELISA was calculated. The clinical and laboratory details of the positive patients were obtained and bivariate analysis was performed. Results: The cut-off for ST IgM ELISA was calculated and found to be 0.38. Of the 636 samples screened, 34 (5.3%) were positive for ST IgM ELISA. Out of the 34 positive samples, only 5 (0....