Biomedical subjects
Publications and source records attributed to R S Murthy.
Seasonality of admissions for mania has been commonly reported. Most reports are from temperature zones. We analyzed admissions for mania covering a 9 year period and looked for any seasonal trends using existing methods. No seasonal variation was found. The hospital lies in the tropical zone with a relatively constant climate. This may influence the seasonal pattern of relapses in affective disorder.
Seasonal relapses of affective disorder are known. We report 12 patients who had season-linked relapses during a prospective follow-up period of 4 years. There were both winter and summer relapses of mania and depression. The centre is in the tropical zone, with lesser variation of sunshine and temperature than in more extreme latitudes. This may inference the pattern of relapse in affective disorder. Differences in relapses between tropical and temperate zones need to be investigated.
A total of 3622 physicians registered in the Association of Physicians of India were contacted through mail and requested to respond to a semistructured questionnaire pertaining to different aspects of medical ethics, with particular focus on informed consent. Six hundred twenty-nine physicians (17.4%) responded to the questionnaire; 86% of the respondents reported having had no formal training in medical ethics; 49% of the subjects who undertook research obtained oral consent only. Majority of the respondents noted the relevance of ethics in different medical situations, though in certain areas like community health and research using animals ethical issues were felt to be less important. Patients' inability to come for regular follow-up and illiteracy were opined to be the main constraints in obtaining consent. Opinion on the amount of information to be imported to research participants as part of informed consent was at variance with standard guidelines. Physicians who reported having had an orientation course in medical ethics and those with prior research experience were more aware of ethical issues. Majority of the professionals desired for inclusion of ethics in medical curriculum.
This investigation examined the nature and frequency of errors in clinical judgment that were displayed by primary health care medical officers before and after short-term training in mental health care. Thirty-nine medical officers who underwent inservice training for 2 weeks were evaluated using standardized case vignettes. Before the training, doctors displayed a sizable percentage of major and minor errors, which dropped significantly following training. Errors were not unique to psychiatric presentations alone, but occurred with respect to vignettes representing physical disorders as well. The results on the whole demonstrate a satisfactory gain in clinical skills of medical officers following the training and highlight the need for continuation of a program of this nature.
Ninety-four urban and 54 rural respondents who had undergone hospitalisation in the previous three years were interviewed using a semistructured interview schedule to ascertain their experiences and opinion regarding ethical issues. The interview focussed particularly on patients' satisfaction and expectations about information provided by medical professionals on various aspects of their illness. Results revealed that both the groups were satisfied with the amount of information they had received during their hospitalisation. Rural respondents were comparatively less satisfied with the information they received regarding complications of illness, possible side effects/complications of treatment, and nature of investigations. A higher proportion of urban respondents required information about other available treatment options and possible outcome of illness if left untreated. A higher number of urban respondents felt that provision of information about illness may have harmful consequences to the patient, and more frequently reported that receiving information was the patient's right. These results suggest that although both urban and rural respondents were sensitive to ethical issues, the response of urban respondents from developing countries is more akin to that of their counterparts in the developed countries.
Ogilvie's syndrome, or acute pseudo-obstruction of the colon is characterized by massive distension of the colon in the absence of organic distal obstruction. The syndrome is associated with various unrelated and, most often, extra-abdominal causes. An association between Ogilvie's syndrome and herpes zoster has been reported only once, by Ceccese et al. in 1985. We present a second such case. This patient did not show evidence of any active illness other than the involvement of the T10 dermatome by herpes zoster. The patient's symptoms of colonic obstruction subsided with resolution of the zosteriform rash.
This study reports the standardisation of a multiple choice questionnaire (MCQ) for evaluating the training of primary care physicians in psychiatry. An item pool of 104 multiple-choice questions of the 'single best response' type was written. This item pool along with an 'MCQ assessment sheet' was mailed to 90 psychiatrists with a request to evaluate the questionnaire. Twenty five psychiatrists responded to the enquiry, of which 22 gave their detailed comments regarding the MCQ. Based on the responses that were received, 14 items were discarded, 77 items were modified and 13 items accepted without any modification. The final pool of 90 items was split into two comparable sets, one for pre-training assessment and the other for post-training assessment. The questionnaire was administered to a group of 32 medical officers and was found to be sensitive in detecting gains in knowledge following training.
Multiple synchronous primary intra-abdominal neoplasms involving more than one organ system are rare, particularly if the appendix is involved. We report a patient with synchronous primary lesions in the colon, appendix, and the kidney. We also discuss the incidence of this entity with respect to sex and age, the organs most often involved in instances of multiple primary lesions, and review the criteria for differentiation of synchronous versus metachronous lesions.
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In the present study dermatoglyphic features were studied in schizophrenics with and without positive family history of schizophrenia. It was found that the difference between normals and schizophrenics was further exaggerated in those schizophrenics with a positive family history for schizophrenia. The implications of the findings and the need for further work are highlighted.
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