Equal Number Of Normal Controls Research Articles

Impact of Age on Cognitive and Psychological Functioning in Patients with Diabetes

Diabetes mellitus is a chronic and non-communicable disease which is also termed as “sugar” emerged as one of the leading causes of global health deterioration. It is associated with decreased physiological and psychological functioning. Age is a significant predictor to evolve diabetes mellitus. Cognitive changes due to diabetes and psychosocial distress are prominent among the population and the risk is high with increasing age range. The aim of the present study is to find out any association between age and cognitive and psychological functioning of patients with diabetes. In the present study, age range of the sample was selected as 40–60 years. A total of 60 individuals of both genders were selected; 30 individuals with diagnosis of diabetes mellitus and equal number of normal controls were included. The cognitive functioning was measured by neuropsychological tools and the psychological functioning was measured by Psychological General Well-being Index. The results indicate that in case of diabetes patients, age was found to be mostly significant and negatively correlated with cognitive and psychological functioning in comparison to normal controls. Findings from the present study suggest that age could be a predictor in changed cognitive and psychological functioning of patients with diabetes and increased age showed poorer cognitive and psychological functioning.

An experimental and algorithm-based study of the spectral features of breast cancer patients by a photodiagnosis approach

In the present study, the spectral diagnosis of blood plasma samples of breast cancer patients and an equal number of normal controls was investigated. A set of ratio parameters was acquired by employing SXS and FES. The samples were also analyzed statistically by employing Welch two-sample t-tests, and the effects of three ratio parameters, R1, R2, and R3, were also studied by plotting them against the subject numbers. A linear discriminant was also applied to verify the exact classification of normal control and breast cancer patients. It was observed that the levels of biofluorophores such as porphyrin, NADH, tryptophan and flavins were elevated 2- to 3-fold for breast cancer patients compared to normal controls, with an accuracy of approximately 100 %. We have also confirmed the validity of the obtained experimental results by using an advanced robust diagnostic algorithm. The experimental results of the current study may have a vital and substantial impact on the detection and screening protocols used for future breast cancer patients. The spectral analysis of body fluid could be of great value to add to and enhance the current procedures with an accuracy of approximately 100 % with limited number of samples. The results and objectives of this preliminary study were encouraging and useful for the discrimination of the features of breast cancer patients compared to those of normal controls.

Glucose Homeostasis Markers in Beta-Thalassemia.

Glycosylated hemoglobin (HbA1c) has been a well-recognized marker of glucose homeostasis among thalassemics. Recently some studies have proposed the role of fructosamine as a better marker as compared with HbA1c. Hence, the study was carried out to find out which marker holds promise among Indian beta-thalassemic children. In this case-control study, 60 diagnosed cases of beta-thalassemia major and equal number of normal controls who were ≥8 years of age were enrolled. HbA1c, fructosamine, and fasting insulin levels were measured in all. Oral glucose tolerance test was done as a gold standard and the measured parameters were compared. HbA1c was significantly higher in cases (7.10% [±0.47%]) than in controls (5.15% [±0.19%]) (P<0.001). Thalassemics with abnormal glucose tolerance had higher HbA1c level (7.34% [±0.57%]) than those with normal glucose tolerance (7.05% [±0.43%]) (P=0.05). Insulin resistance was noticed among thalassemics with abnormal glucose tolerance as compared with their normal counterparts (P=0.04). No significant difference was found in fructosamine levels between cases (239.80 [±31.80] μmol/L) and controls (234.10 [±21.34] μmol/L) (P=0.25) or between thalassemics with abnormal glucose tolerance (243.92 [±21.94] μmol/L) and their normal counterparts (238.77 [±33.93] μmol/L) (P=0.62). The use of HbA1c as a diagnostic marker for diabetes in hemolytic anemias has to be done with caution as its baseline values are higher in them. Despite this finding, HbA1c continues to be a good marker for worsening glucose homeostasis in thalassemics as higher values were found in thalassemics with abnormal glucose tolerance compared with their normal counterparts. The present study did not find any relationship of fructosamine levels with impaired glucose tolerance in beta-thalassemia.

Risk factors for severe acute malnutrition in under-five children: a case-control study in a rural part of India

ObjectivesThe present study was planned to identify some of the risk factors of severe acute malnutrition (SAM) in under-five children in a rural part of India. Study designCase-control study. MethodsThe study was carried out in rural areas of Yavatmal district. A total of 737 cases (under-five SAM children) and an equal number of normal controls were included in the study. Data were collected using a structured questionnaire. Binary logistic regression was used for multivariate analysis using a hierarchical model. ResultsThe odds of a child being in the SAM category increased significantly if the family: was below the poverty line, have a kuccha house, have more children in the family, have less rooms in the house, have a working mother, has a mother with a lower level of education, have an unemployed father, did not use any water purification measure, did not always ensure parents washed their hands before feeding a child, did not wash hands with soap and water after defecation, have a father with any addictive habit like tobacco or alcohol consumption, have a maternal height <145 cm, have a maternal weight <45 kg, have a lower age at marriage for mothers, had an institutional delivery, have the same food utilized more than once in a day, have no age-appropriate vaccination, give prelacteal feeds, have a lower frequency of breast feeding, do not use semisolid food during the weaning period, exclusively breast feed for less than four months or more than six months, had low birth weight, have five or more episodes of illness in the previous year, have ≤3 feeds per day apart from breast milk, and not initiation of breast feeding within 30 min of birth. ConclusionRisk factors identified in the present study can be addressed through health system interventions. The strongest association was observed with child feeding practices; thus, more emphasis is required in nutritional education and counselling in strategies to fight undernutrition.

Neuropsychological assessment in obsessive-compulsive disorder.

Background:Neuropsychological deficits in obsessive-compulsive disorder (OCD) have been encouraged by brain imaging studies suggesting a putative fron to- striatial biological basis of the condition. Studies of neuropsychological functions in OCD have documented deficits in several cognitive domains, particularly with regard to visuospatial abilities, executive functioning, motor speed and memory. The Aim of the present study was to assess neuropsychological profile of patients with OCD. Objectives of the study were to assess and compare the neuropsychological profile of patients with OCD and matched healthy controls.Materials and Methods:Twenty clinically stable outpatients with ICD-10 diagnosis of OCD and equal number of normal controls matched for age, education, gender and handedness were studied using a battery of neuropsychological tests. The tests consisted of verbal and performance tests of intelligence, memory, perceptual motor functions, set test and Wisconsin Card Sorting Test (WCST).Results:On perceptual-motor functions, verbal fluency, executive functions (WCST), intelligence and memory patients with OCD did not show impairments comparable to healthy controls. An attempt to correlate the test findings with the duration of illness, stability of illness and the average drug dose was made and it was found that there was no correlation between the two.Conclusion:The present study does not provide evidence for a localized neuropsychological/cognitive impairment in OCD in cases that are stable for at least three months. Absence of impairments in perceptual-motor functions, verbal fluency, executive functions (WCST), intelligence, and memory does not agree with the results of other studies using these tests.

Disorganization of semantic memory underlies alogia in schizophrenia: An analysis of verbal fluency performance in Japanese subjects

Patients with schizophrenia exhibit impaired semantic memory as well as deficits in a wide range of language-related functions, such as verbal fluency, comprehension and production of complex sentences. Since language and memory disturbances may underlie some of the psychotic symptoms of schizophrenia, the present study investigated the specific association between alogia (i.e. poverty of speech, poverty of content of speech, blocking, and increased latency of response) and semantic memory organization using the category fluency task (CFT) as a measure of verbal fluency. Thirty-eight patients with schizophrenia and an equal number of normal controls entered the study. Semantic structure was derived from multidimensional scaling analysis using sequential word outputs from the CFT. Patients with schizophrenia revealed disorganized semantic structure (e.g. irregular association of category members) compared with controls, consistent with previous reports. The patients were then divided into two groups, i.e. alogia- and non-alogia subjects, based on the Alogia scores from the Scale for the Assessment of Negative Symptoms (SANS). The symptom-based analysis showed that the semantic structure for the alogia group (Alogia score ≤2) was more disorganized than that for the non-alogia group (Alogia score <1) although the number of words produced did not differ between the two groups. The results of cluster analysis revealed the presence of bizarre coherence specifically in the alogia group. These results indicate that semantic memory disorganization may contribute to the symptom of alogia in schizophrenia. In addition, this is one of the few studies that examined verbal fluency in Japanese patients with schizophrenia and suggest that the language abnormalities in schizophrenia are universal.

Effect of orthography on the verbal fluency performance in schizophrenia: examination using Japanese patients

Letter fluency performance is less impaired than the category fluency performance in alphabetical-language speakers with schizophrenia. The purpose of this study was to determine whether the same pattern in the performance on the two verbal fluency tasks exists in subjects using a non-alphabetical language. In the Japanese orthography, there is one-to-one correspondence between sound (syllable) and graphemes (“kana” script), in contrast to one-to-many associations in alphabetical languages (e.g. English, French). The category fluency task (ANIMAL, FRUIT) and the letter fluency task (“KA”, “TA” in “kana” script) were administered on 38 patients with schizophrenia and the equal number of normal controls. In order to examine the influence of psychotic symptoms on the verbal fluency performance, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were administered. The patients performed significantly worse both in the letter- and category fluency tasks compared with control subjects. However, performance on the letter fluency task and category fluency task was similarly impaired in Japanese patients with schizophrenia, unlike the results in previous studies with alphabetical-language speakers. On the other hand, Alogia symptoms, as assessed by SANS, was a significant predictive variable in the regression model for the category fluency task score (ANIMAL), whereas the factor of the other domains of negative symptoms as a whole was a significant predictive variable in the model for the letter fluency task score (TA), which confirmed the findings in previous studies with alphabetical-language subjects. These results suggest that the pattern of impairment in the verbal fluency performance in schizophrenia is dependent on the specific language systems used by the patients although the degradation of the verbal fluency performance is influenced by some types of negative symptoms irrespective of the language system.

Tongue Deviation in Acute Ischaemic Stroke: A Study of Supranuclear Twelfth Cranial Nerve Palsy in 300 Stroke Patients

It is generally believed that the supranuclear innervation of the hypoglossal nucleus is bilateral and symmetrical. The aim of this work is to study the frequency and clinical characteristics of supranuclear tongue palsy in unilateral stroke. 300 patients with acute unilateral ischaemic motor strokes (excluding those in the lower brainstem) and an equal number of normal controls were studied for the presence of tongue deviation in a standardised manner. 29% of stroke patients and 5% of controls had tongue deviation (p < 0.00001). Deviation was always to the side of the limb weakness. In patients with a history of stroke, it occurred more frequently in those with previous stroke on the contralateral side. Tongue deviation was most common in patients with clinical features of the non-lacunar stroke subtype (56%) or in those with cortical or large subcortical infarctions on brain CT scan (55 and 45%, respectively). All tongue deviations were associated with supranuclear 7th nerve palsy. Dysphagia and dysarthria occurred in 43 and 90% of patients with tongue deviation. Weakness of the arm was significantly associated with presence of tongue deviation. Tongue deviation in unilateral stroke most likely results from asymmetrical supranuclear control of the 12th cranial nerve in many individuals. The finding that it occurs relatively commonly in large (non-lacunar) infarcts and its association with dysphagia may have clinical utility.

Comparison Between the Panic Disorder with Agoraphobia Patients and Normal Controls on the Basis of Cognitions Affect and Physiology

Research using ambulatory monitoring and cognitive sampling procedures has revealed the importance of negatively biased cognitions in panic attacks and panic disorder. However, the normal population has never been investigated on the basis of these procedures and it is still unclear how patients deviate from them on the basis of negative cognitions and their interaction with affect and physiology. The present study investigated these issues by comparing 15 panic disorder patients with an equal number of normal controls. The results revealed that, although the pattern of reporting cognitions was similar, the two groups differed on type and content of the cognitions. In general, there were significant differences between the two groups for neutral and negative cognitions. Patients experienced high anxiety levels that were associated with cognitions of negative affect. There was a low frequency of reported panic attacks in the patients group. Possible reasons for the limited number of panic attacks are discussed.

Reduced basal ganglia volumes in Tourette's syndrome using three‐dimensional reconstruction techniques from magnetic resonance images

Using a 1.5-tesla GE Signa MR scanner, we imaged the brains of 14 right-handed Tourette's syndrome (TS) patients (11 men, three women), aged 18 to 49 years, who had minimal lifetime neuroleptic exposure. We also studied an equal number of normal controls individually matched for age, sex, and handedness and group-matched for socioeconomic status. We circumscribed basal ganglia on sequential axial images from spin-echo proton density-weighted acquisitions (TR 1,700, TE 20; slice thickness, 3 mm with 1.5-mm skip) and submitted the images for three-dimensional processing at a computer graphics workstation. Our hypothesis of lenticular nucleus volume reduction in TS was confirmed for the left- but not the right-sided nucleus. Post hoc analyses revealed smaller mean volumes of the caudate, lenticular, and globus pallidus nuclei compared with controls on both the right and left. Further analyses of basal ganglia asymmetry indices suggest that TS basal ganglia do not have the volumetric asymmetry (left greater than right) seen in normal controls. These findings confirm and extend prior phenomenologic, neuropathologic, and neuroradiologic studies that implicate the basal ganglia in the pathogenesis of TS.

The pancreas, primary biliary cirrhosis and the dry gland syndrome.

Pancreatic exocrine function was studied in 13 patients with primary biliary cirrhosis (PBC) and an equal number of normal controls. Pancreatic fluid output and maximum bicarbonate concentrations were similar in both groups. Comparison of PBC patients with and without sicca syndrome revealed no significant differences.

Vestibular Reactivity to Caloric Stimulation in Schizophrenics

Abnormalities in the vestibular reactions in schizophrenics have been reported in the literature. Pekelsky (1921) observed transitory lack of caloric response in two cases of catatonic stupor. Rosenfeld (1926) described four cases of acute catatonia in which on calorization a slow deviation appeared instead of the physiological response. Claude, Baruk and Aubry (1927) examined four cases of catatonia, eight of hebephrenia and one of dementia paranoides. In one of the catatonic cases no caloric or galvanic response could be elicited, and in the three others the reactions were diminished. The other cases showed normal reactions. The authors stated that a diminution of the responses could sometimes be observed in hysteria. Claude, Bourguignon and Baruk (1932) found the Chronaxie of the vestibular nerves greatly increased in patients with catalepsy, but normal after the disappearance of that symptom. Joo and Meduna (1935) stated that in old-standing cases of schizophrenia a lack or a considerable diminution of the vestibular responses could nearly always be found. Sercl and Vinar (1937) examined the vestibular reactivity in twelve cases of hebephrenia and thirteen cases of paranoid schizophrenia. The responses to rotation were normal in all cases. The caloric responses were found to be diminished or lacking. Lack of caloric response was more frequent in the hebephrenic than in the paranoid cases. Löwenbach (1936), working on Gjessing's cases of periodic catatonia, carried out quantitative investigations taking into account the latency period of nystagmus, its duration and the number of oscillations. He examined thirty cases, each of them repeatedly, and attempted to correlate the results of the tests with the periodical changes in the clinical picture. He found that shortly before and during periods of stupor the vestibular reactivity dropped, and that sometimes only a slow deviation could be elicited. The lowering of the frequency was due to the prolongation of the slow phase. The abnormalities were independent of the duration of the illness, and in some old-standing cases the response was normal. Sometimes a temporarily diminished reactivity was noticed which did not coincide with a change in the clinical picture. Löwenbach noted frequent and often abrupt changes in individual cases, and in some he observed transitory complete loss of reaction. Angyal and Blackman (1940) studied vestibular reactivity to caloric and rotatory stimulation in 58 unselected male schizophrenics and in 20 normal controls. The response to caloric stimulation was found to be considerably lowered, the rotatory response only slightly reduced. There was no correlation to the duration of hospitalization or to the conventional subtypes of schizophrenia. However, in a group of five patients with extreme apathy, indifference and poverty of mental contents the reactivity was particularly low. In cases with a periodical course the vestibular reactivity was distinctly lower during the catatonic periods than during the intervals. The same authors (1941) investigated the nystagmic reactions to caloric stimulation under the influence of alcohol, hyperpnoea and CO-inhalation in schizophrenics and normal persons. While in normals alcohol intake results in an increase in the frequency of the nystagmus, in schizophrenics a decrease was observed. CO, which normally has a depressing effect on the nystagmic reaction, produced an increase in schizophrenics. Hyperpnoea, while causing an increase in normals, had the opposite effect in schizophrenics. Freeman and Rodnick (1942) studied the amount of sway induced by rotation in thirty schizophrenics and in an equal number of normal controls. The patients were found to be significantly less reactive than the normal subjects.