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Kalra B.,Bharti Hospital | Kalra S.,Bharti Hospital | Balhara Y.P.S.,National Drug Dependence Treatment Center
Journal of the Pakistan Medical Association

Though the importance of psychological factors in the natural history, and the management of diabetes, cannot be overstated, these factors are sometimes not discussed adequately in current literature. Lack of trained manpower, time, and other resources, tends to detract diabetes care professionals from paying attention to this field. This review discusses simple, practical ways of psychological assessment and psychological management, in a manner relevant not only to Pakistan, but to other resource challenged settings as well. The paper underscores the fact that improvements in our understanding of psychological aspects of diabetes should be considered worthy of inclusion in the column: recent advances in endocrinology. Source

Quraishi R.,National Drug Dependence Treatment Center | Jain R.,National Drug Dependence Treatment Center | Kakkolil A.P.,All India Institute of Medical Sciences
Addictive Disorders and their Treatment

Naltrexone is a potent narcotics antagonist, but its utility is limited by the patient's noncompliance. The present study was conducted to ascertain the naltrexone levels in patients maintained on daily dose of naltrexone along with their biochemical profile. Methods: Patients, fulfilling DSM (IV) criteria, who were on naltrexone maintenance program were included. Two hours after the intake of 50mg of naltrexone, 5mL of the blood and urine samples were collected from each patient. Plasma was separated for naltrexone estimation and urinalysis was performed to ascertain illicit opioid use. The biological markers and sociodemographic profile were also recorded. Results: The study included 10 male patients. The median age of patients was 28.5 years. The duration of drug use varied from 6 months to 27 years, with a median age of 8 years of opioid use. One patient reported highrisk sexual behavior. The biochemical profile was within the normal range except for 1 patient. The plasma concentration of naltrexone ranged from 0.12 to 0.70 lg/mL with a mean value of 0.49 lg/mL. Conclusions: These results suggest that plasma naltrexone levels along with the biochemical profile can be used as a reliable measure for assessment of compliance of antagonist therapy in opioid-dependent patients in Indian population. The findings need to be replicated with a bigger sample size. Copyright © 2012 by Lippincott Williams & Wilkins. Source

Sharma R.,Consultant Psychiatrist | Balhara Y.P.S.,Lady Hardinge Medical College and SSK Hospital | Sagar R.,National Drug Dependence Treatment Center | Deepak K.,All India Institute of Medical Sciences | Mehta M.,National Drug Dependence Treatment Center
Journal of Cardiovascular Disease Research

Background: The current study aims at assessment of heart rate variability among children and adolescents with childhood anxiety disorder, using the case-control design. Materials and Methods: The study was carried out at a tertiary care multispecialty hospital. It included 34 children and adolescents with diagnosis of childhood anxiety disorder, in the age range of eight to eighteen years, and 30 age- and sex-matched healthy controls. Heart-rate variability was studied using the standard protocol. Results: Significantly reduced variability of the heart rate was observed in both the time as well as frequency domains in the disorder group as compared to the control group. These findings indicate decreases in the sympathetic and parasympathetic activity in the disorder group, thus representing diminished physiological variability at rest. Conclusions: The notion of autonomic inflexibility, as seen in the current study, has important implications for stability in biological systems. The loss of variability in the physiological systems in general, and in the cardiovascular system in particular, has an association with a number of diseases and dysfunctions. Source

Sheng L.-X.,Capital Medical University | Sheng L.-X.,National Drug Dependence Treatment Center | Sheng L.-X.,National Center for Clinical Trials of Psychotropic Drugs | Tang Y.-L.,Capital Medical University | And 7 more authors.
Nicotine and Tobacco Research

Bupropion is a first-line pharmacological aid for smoking cessation; however, no clinical trials have been conducted in a Chinese population. We enrolled 248 smokers in a hospital-based, randomized, smoking cessation trial conducted at four outpatient centers in Beijing. A total of 123 participants received an 8-week course of sustained-release bupropion (Bup-SR) and 125 participants received 8 weeks of placebo. All participants received brief education and counseling on smoking cessation. We determined rates of abstinence and smoking reduction based on chemical verification and self-report at 8 and 12 weeks. At the end of the medication treatment (8 weeks) and at the end of the trial (12 weeks), the abstinence rates for Bup-SR were 29.3% and 39.8%, respectively, and 10.4% and 8.0% for placebo, respectively (both p <.001). Bup-SR was also superior to placebo in reducing cigarettes per day and urinary cotinine levels. Bup-SR is efficacious for smoking cessation in healthy Chinese patients treated in the outpatient setting. It is well tolerated with a few mild side effects. © The Author 2012. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Source

Ray R.,National Drug Dependence Treatment Center | Vaswani M.,National Drug Dependence Treatment Center | Deb K.S.,National Drug Dependence Treatment Center | Sethi H.,National Drug Dependence Treatment Center | And 3 more authors.
Indian Journal of Physiology and Pharmacology

Background & Objectives: A combination of buprenorphinenaloxone (Addnok-N) tablets has been recently introduced in India as treatment for Opioid dependence. This study was undertaken to evaluate the possible adverse consequences following use of the buprenorphinenaloxone tablets through post marketing surveillance. Methods: National Drug Dependence Treatment Centre (NDDTC), AIIMS, India, monitored all patients receiving buprenorphine-naloxone combination tablets from the centre over a period of two and half years. Evaluation included subjective and objective side effect checklist, physical examination, and laboratory investigation. Results: Data was obtained from 1132 observations among 158 patients. Commonly reported medication effects, like muscle aches (44.0%), sleepiness (44.0%), relief from pain (41.3%), etc; are expected in opioid substitution treatment. Laboratory investigations were mostly normal except for liver enzyme abnormalities (52.2% of cases). Eight adverse events were reported in the study. No dangerous event or mortality was reported during the study. Source

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