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Panda UK, Sahoo SS, Samantaray S. "Harm reduction approach for tuberculosis and substance use disorders: A review of approaches and implications in the Indian context". Indian J Tuberc 2024; 71:219-224. [PMID: 38589127 DOI: 10.1016/j.ijtb.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/05/2023] [Accepted: 09/22/2023] [Indexed: 04/10/2024]
Abstract
There are limitations to traditional treatment approaches in addressing the needs of individuals with dual comorbidity of TB and SUD. The concept of harm reduction as a distinct approach to addressing substance use, focusing on minimising the negative consequences associated with it rather than advocating for complete abstinence. Different harm reduction strategies, such as opioid substitution therapy, needle and syringe programmes, testing for viral infections etc. have been effectively employed for SUDs in past. Similarly, TB risk minimization approaches like improving housing and nutrition and focused testing strategies are considered as harm reduction strategies for TB management. The relationship between tuberculosis (TB) and substance use disorders (SUDs) involves a complex interplay of biopsychosocial factors. It is crucial to prioritise integrated and closely monitored care in order to address the treatment challenges and potential drug interactions that may arise. In light of the acknowledged challenges like limited awareness, infrastructure, drug resistance, and stigma, it is imperative to explore potential avenues for the implementation of harm reduction strategies targeting individuals with comorbid TB and SUD in India. Potential strategies for addressing the issue includes a range of measures, such as augmenting investments in healthcare, integrating policies, tackling social determinants, and establishing shared platforms for psychosocial rehabilitation.
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Affiliation(s)
- Udit Kumar Panda
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India.
| | - Soumya Swaroop Sahoo
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Swayanka Samantaray
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India
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Pattnaik JI, Panda UK, Chandran S, Padhy S, Ravan JR. Treatment resistant psychosis in children and adolescents and clozapine: Nuances. Front Psychiatry 2023; 14:1014540. [PMID: 36911129 PMCID: PMC9998521 DOI: 10.3389/fpsyt.2023.1014540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/25/2023] [Indexed: 03/14/2023] Open
Abstract
With proliferation in research on high-risk psychosis spectrum diseases, it is crucial to distinguish a prodrome or psychosis-like episode in children and adolescents from true psychosis. The limited role of psychopharmacology in such circumstances is well-documented, underlining the difficulties in diagnosing treatment resistance. To add to the confusion is emerging data on the head-to-head comparison trials for treatment-resistant and treatment-refractory schizophrenia. Clozapine, the gold-standard drug for resistant schizophrenia and other psychotic psychopathology, lacks FDA or manufacturer guidelines for use in the pediatric population. Possibly due to developmental pharmacokinetic (PK) considerations, clozapine-related side effects are more commonly seen in children than adults. Despite evidence of an increased risk for seizures and hematological problems in children, clozapine is widely used off-label. Clozapine reduces the severity of resistant childhood schizophrenia, aggression, suicidality, and severe non-psychotic illness. There is inconsistent prescribing, administration, and monitoring of clozapine, and limited database evidence-backed guidelines. Despite the overwhelming efficacy, problems remain regarding unambiguous indications of use and risk-benefits assessments. This article reviews the nuances in the diagnosis of treatment resistance psychosis in childhood and adolescents and its management, in particular highlighting the evidence base for clozapine in this population group.
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Affiliation(s)
| | - Udit Kumar Panda
- Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suhas Chandran
- Child and Adolescent Psychiatry, St. Johns Medical College and Hospital, Bengaluru, India
| | - Susanta Padhy
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
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Narasimha VL, Shukla L, Mukherjee D, Menon J, Huddar S, Panda UK, Mahadevan J, Kandasamy A, Chand PK, Benegal V, Murthy P. Complicated Alcohol Withdrawal-An Unintended Consequence of COVID-19 Lockdown. Alcohol Alcohol 2020; 55:350-353. [PMID: 32400859 PMCID: PMC7239212 DOI: 10.1093/alcalc/agaa042] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/23/2020] [Accepted: 04/25/2020] [Indexed: 12/04/2022] Open
Abstract
AIM To assess the impact of COVID-19-related lockdown in India on alcohol-dependent persons. METHOD We examined the change in the incidence of severe alcohol withdrawal syndrome presenting to hospitals in the city of Bangalore. RESULTS A changepoint analysis of the time series data (between 01.01.20 to 11.04.20) showed an increase in the average number of cases from 4 to 8 per day (likelihood ratio test: χ2 = 72, df = 2, P < 0.001). CONCLUSION An unintended consequence of the lockdown was serious illness in some patients with alcohol use disorders.
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Affiliation(s)
- Venkata Lakshmi Narasimha
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Lekhansh Shukla
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Diptadhi Mukherjee
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Jayakrishnan Menon
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Sudheendra Huddar
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Udit Kumar Panda
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Jayant Mahadevan
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Arun Kandasamy
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Prabhat K Chand
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Vivek Benegal
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
| | - Pratima Murthy
- Centre for Addiction Medicine, Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, 560029, India
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Jhanjee S, Varshney MK, Panda UK, Kaloiya GS, Dayal P, Yadav D. Evaluation of a training workshop on tobacco cessation: capacity building initiative in India. Tob Induc Dis 2018. [DOI: 10.18332/tid/84169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Prader-Willi syndrome is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Maladaptive behaviours, cognitive impairment, and impediments in speech and language seriously affect the early development and long-term functioning of individuals affected by the illness. We present a case of a 9-year-old child with Prader-Willi syndrome whose behavioural symptoms were treated with low-dose antipsychotic medications.
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Affiliation(s)
- Satyakam Mohapatra
- Mental Health Institute, Sriram Chandra Bhanj (SCB) Medical College, Cuttack, Odisha, India
| | - Udit Kumar Panda
- Mental Health Institute, Sriram Chandra Bhanj (SCB) Medical College, Cuttack, Odisha, India
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Mohapatra S, Panda UK, Sahoo AJ, Dey S, Rath N. Neuropsychiatric manifestations in a child with agenesis of the corpus callosum. J Neurosci Rural Pract 2015; 6:456-7. [PMID: 26167049 PMCID: PMC4481820 DOI: 10.4103/0976-3147.158758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Satyakam Mohapatra
- Department of Psychiatry, Mental Health Institute, S.C.B Medical College, Cuttack, Odisha, India
| | - Udit Kumar Panda
- Department of Psychiatry, Mental Health Institute, S.C.B Medical College, Cuttack, Odisha, India
| | - Alok Jyoti Sahoo
- Department of Psychiatry, Mental Health Institute, S.C.B Medical College, Cuttack, Odisha, India
| | - Snehanshu Dey
- Department of Psychiatry, Mental Health Institute, S.C.B Medical College, Cuttack, Odisha, India
| | - Neelmadhav Rath
- Department of Psychiatry, Mental Health Institute, S.C.B Medical College, Cuttack, Odisha, India
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