1.A Study Of The Relationship Of Epilepsy With Psychoactive Substance Dependence In A Prison Population
Pankaj Sureka ; Sandeep Govil ; Naveen Kumar Girdhar ; Mukesh Kumar ; Vikas Singhal
ASEAN Journal of Psychiatry 2014;15(2):153-163
Objective: This study aimed to determine the prevalence of epilepsy in prisoners
suffering from substance dependence and the relationship between onset of
epilepsy and substance dependence in a prison population. Methods: The present
cross-sectional study in a prison population was conducted in Central Jail (CJ),
New Delhi, India over a period of 3 months. The convenience sample consisted of
900 subjects. The study group consisted of 450 prisoners taken from the deaddiction
ward and the rest were placed in the control group. Physical
examination and Mini Mental State Examination (MMSE) of subjects were done
to make necessary exclusion. Assessment tools were applied in the order starting
from MMSE, Basic Socio-demographic Performa, Present State Examination
(PSE), and Addiction Severity Index (ASI). Results: The average ages of study
and control subjects were 34.5 + 2.3 years (mean + standard deviation) and 35.6
+ 3.6 years respectively. Prevalence of epilepsy among substance using prisoners
was 1.4 times higher than in non-substance using prisoners. Alcohol, opioid, and
cannabis, either alone or in various combinations, were the most commonly used
substances. Subjects suffering from epilepsy were likely to have higher chances
of consuming three or more substances than those without problem of epilepsy.
Study subjects suffering from epilepsy compared with those without epilepsy
performed worse in all parameters. This is indicative of higher severity of
psychoactive substance dependence. Conclusion: Findings of high prevalence
rate of epilepsy and co-morbid substance dependence highlight the need for
better screening among epileptic subjects for substance abuse at entry into
prison for effective treatment while in custody, and at follow-up on release.
Specialist addiction services for prisoners have a considerable impact in a wellplanned
intervention programme for prisoners with substance use and comorbid
epilepsy. ASEAN Journal of Psychiatry, Vol. 15 (2): July – December
2014: 153-163.
2.Sudarshan Kriya For Male Patients With Psycho Active Substance Dependence: A Randomized Control Trial
Pankaj Sureka ; Sandeep Govil ; Debadutta Dash ; Chandika Dash ; Mukesh Kumar ; Vikas Singhal
ASEAN Journal of Psychiatry 2015;16(1):28-37
Objectives: The aims of the study were to investigate whether Sudarshan Kriya
(SK), a form of Yoga and related practices can lead to increased Global
Assessment of Functioning (GAF) and increased feeling of wellness in patients
with substance dependence. Method: This was a 3-month single blind parallel
randomized controlled study with sample size of 111 patients which were
allocated by simple randomization to two groups. Study subjects were involved
in an intensive program of Sudarshan Kriya and practices (SK&P) which they
practised daily for 6 weeks. The control subjects were instructed to sit in an
armchair with their eyes closed and pay gentle attention to their breath. A
period sample of three months consisting of all patients admitted in De-addiction
(DAC) ward fulfilling study criteria was taken. Only male patients diagnosed to
be suffering from Substance Dependence by ICD-10 (DCR) criteria, aged
between 18-65 years were included in this study. The assessment tools were the
Basic Socio-demographic Performa, Mini Mental State Examination (MMSE),
Severity of Dependence Scale (SDS), Schedule for Clinical Assessment in
Neuropsychiatry (SCAN) based clinical interview, Global Assessment of
Functioning (GAF) and Psychological General Well Being (PGWB). These
assessments were conducted before starting the intervention and six weeks
thereafter. Results: In the final analysis, number of participants analyzed in the
study group was 55 and in the control group was 56. Majority of subjects were
unemployed, married individuals who did not have occupational skills of more
than skilled labour level. After six weeks of SK&P, statistically significant
improvement in study subject dimensional scores of GAF (48.43+/- 0.08 to
66.77+/-0.14), Anxiety (ANX) (9.64+/-0.52 to 15.66+/-0.38), Depressed Mood
(DEP)(7.19+/-0.2 to 9.18+/-0.37), Positive Well Being (PWB)(10.28+/-0.61 to
12.92+/-0.73), General Health (GH)(7.74+/-0.18 to 9.75+/-0.22) and Total
PGWB(41.46+/-0.35 to 59.28+/-0.63) were noticed. However, when compared
with control subjects, improvement was statistically significant in the case of
GAF (p=0.000158), Anxiety (ANX)(p=0.011), Positive Well Being
(PWB)(p=0.02), General Health (GH)(p=0.02) and Total PGWB(p=0.05); but not
in the case of Depressed Mood (DEP), Self Control (SC) and Vitality.
Conclusion: Practicing SK&P helps in improving Global Assessment of
Functioning, Psychological General Well Being, General Health (GH) and
positive well being of an individual. SK&P also causes significant reduction in
anxiety levels of an individual.
3.Evaluation of the optimal sequence of adjuvant chemotherapy and radiation therapy in the treatment of advanced endometrial cancer
Jennifer MCEACHRON ; Nancy ZHOU ; Christina SPENCER ; Lisa SHANAHAN ; Carolyn CHATTERTON ; Pankaj SINGHAL ; Yi-Chun LEE
Journal of Gynecologic Oncology 2020;31(6):e90-
Objective:
The optimal sequence of adjuvant chemoradiation in the treatment of advanced endometrial carcinoma (EC) remains unclear. We sought to evaluate the outcomes of patients treated with chemoradiation in sandwich fashion (chemotherapy-radiotherapychemotherapy; CRC), versus those treated sequentially (chemotherapy-radiotherapy; CR) (radiotherapy-chemotherapy; RC), to determine if there is a survival advantaged associated with a particular treatment sequence.
Methods:
A multicenter retrospective analysis of patients with stage III and IV EC from 2000-2018 was conducted. Inclusion criteria were patients who had undergone comprehensive surgical staging/tumor debulking; followed by adjuvant chemoradiation. Differences in the frequencies of adverse events were evaluated using Pearson's χ 2 test. Progression free survival (PFS) and overall survival (OS) rates were calculated using Kaplan-Meier estimates.
Results:
Final analysis included 152 patients; 36.8% (n=56) CRC, 28.9% (n=44) CR, and 34.2% (n=52) RC. Histology included 44.0% endometrioid, 47.5% serous and 8.5% clear cell tumors. There was no difference in the frequency of histology (p=0.973), stage (p=0.143), cytoreduction status (p=0.932), or treatment delays (p=0.571) between adjuvant therapy sequences. The most frequent location of disease recurrence was abdomen. The median PFS favored CRC versus CR or RC (36-months vs. 22-months and 24-months, respectively) (p=0.038), as did the median OS (48-months vs. 28-months and 34-months, respectively) (p=0.003). CRC demonstrated superiority over CR and RC sequencing in terms 3-year PFS (55% vs. 34% and 37%, respectively) and 3-year OS (71% vs. 50% and 52%, respectively).
Conclusions
Adjuvant chemoradiation delivered in CRC sequence was associated with improvements in both PFS and OS compared to alternant therapy sequencing.