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Biomedical subjects

P Tharyan

Publications and source records attributed to P Tharyan.

9 recordsLinked to original sources
PubMed2003

Prevalence of HIV infection in psychiatric patients attending a general hospital in Tamil Nadu, south India.

An anonymous, unlinked study was conducted to detect antibodies to HIV-1 or HIV-2 infections in 1,160 consecutive, newly registered, adult psychiatric outpatients at a general hospital in South India to determine whether psychiatric patients presenting to general hospitals are a population at high risk for HIV infection and should be routinely screened. The seroprevalence of HIV infection (12/1160; 1.03%; 95% CI = 0.4-1.6%) did not approximate rates expected of a high-risk group compared to the national (0.7%) or regional community (1.8%) prevalence. It did not differ significantly from HIV seroprevalence in non-psychiatric patients (233/35450; 0.7%; 95% CI = 0.57-0.74%) who were systematically screened (relative risk = 1.57; 95% CI = 0.88-2.80) during the same period, but was greater than the seroprevalence in healthy blood donors (0.5%; p = 0.02; relative risk = 2.15 95% CI = 1.17-3.95). Non-psychiatric patients were also more likely to be HIV infected than blood donors (p = 0.02; relative risk = 1.37; 95% CI = 1.05-1.78). These findings have implications for HIV testing policies among psychiatric and non-psychiatric patients presenting to general hospitals in India.

Adolescent↗
PubMed2000

Electroconvulsive therapy for schizophrenia.

BACKGROUND: Electroconvulsive therapy (ECT) involves the induction of a seizure (fit) for therapeutic purposes by the administration of a low frequency electrical stimulus shock via electrodes applied to the scalp. At present it is used for those with schizophrenia but its effects are unclear. OBJECTIVES: To determine whether electroconvulsive therapy (ECT) results in clinically meaningful benefit with regard to global improvement, hospitalisation, changes in mental state, behaviour and functioning in those with schizophrenia. SEARCH STRATEGY: Electronic searches of Biological Abstracts (1982-1996), EMBASE (1980-1996), Medline (1966-1996), PsycLIT (1974-1996) and SCISEARCH (1996) were undertaken. The references of all identified studies were investigated. SELECTION CRITERIA: All randomised controlled trials that compared ECT with placebo, 'sham ECT', non-pharmacological interventions and antipsychotics for people with schizophrenia, schizoaffective disorder or chronic mental disorder. DATA COLLECTION AND ANALYSIS: The reviewers extracted the data independently and analysed the data on an intention to treat basis. MAIN RESULTS: Less people with schizophrenia treated with ECT showed no improvement in general functioning when compared to those given placebo in the short term (OR 0.48 CI 99% 0.26-0.90). This effect, however, does not last. However, ECT is less effective than antipsychotic drug treatment for those with schizophrenia. Limited evidence exists to suggest that combining antipsychotic drugs and ECT increases the rate and extent of clinical improvement, in the short term, in one out of every five to six people. The evidence for the efficacy of ECT in the medium to long term is equivocal. Electroconvulsive therapy is also more effective than the now obsolete insulin coma treatment. REVIEWER'S CONCLUSIONS: There is some evidence to support the use of ECT for those with schizophrenia for short term relief of symptoms. Electroconvulsive therapy may be advocated as an adjunct to antipsychotic medication for those with schizophrenia who show a limited response to medication alone but the evidence for this is not strong. In fact in spite of more than five decades of widespread clinical use, the administration of ECT to those with schizophrenia lacks a strong research base.

Electroconvulsive Therapy↗
PubMedDate not supplied

Attitudes of 'tomorrow's doctors' towards psychiatry and mental illness.

BACKGROUND: Attitudes to psychiatry and mental illness among medical undergraduates are key factors in determining their choice of psychiatry as a career and willingness to deal with psychiatric disorders in general practice. METHODS: The responses of 108 medical students from the first and fourth year batches not exposed to psychiatry were compared with those of 139 final year students and interns who had completed varying components of psychiatric training using validated questionnaires that assessed their attitudes to psychiatry and mental illness, and their interest in psychiatry as a career choice. RESULTS: A greater proportion of students exposed to psychiatric training endorsed positive attitudes to mental illness than those not exposed (odds ratio=0.4; 95% confidence intervals: 0.21-0.71; p=0.002). The overall attitude towards psychiatry did not differ between students before or after psychiatric education. Women students were more likely to consider a career in psychiatry (odds ratio=2.9; 95% confidence intervals: 1.36-6.21; p = 0.004), but the proportion of students of either gender wishing to pursue psychiatry as a career option did not differ significantly with psychiatric training. CONCLUSION: Psychiatric education positively influences the attitudes of medical students towards mental illness and some aspects of psychiatry but does not increase the number of students wishing to pursue psychiatry as a career. Urgent and radical changes in psychiatric education for undergraduate medical students are required to meet current and future requirements of medical personnel trained to deal with psychiatric disorders.

Attitude of Health Personnel↗
PubMedDate not supplied

Electro convulsive therapy in a pre-pubertal child with severe depression.

Electro Convulsive Therapy (ECT) in pre-pubertal children is a controversial and underreported treatment. Even though the effectiveness and side effects of ECT in adolescents are comparable with those in adults, there is a pervasive reluctance to use ECT in children and adolescents. We report the case of a pre-pubertal child in an episode of severe depression with catatonic features, where a protracted course of ECT proved life-saving in spite of prolonged duration of seizures and delayed response to treatment. The case illustrates the safety and efficacy of ECT in children. Relevant literature is also reviewed along with the case report.

Child↗