changes in mental health policies that have made dangerousness a relatively more common reason for admission (as non-violent patients are more likely tobe treated in the community) overcrowding lack of sufficiently experienced staff increased use of illegal substances.

Restrictions of diet and activities Increased self-care needs Prospect of complications problems due to complications eg loss of sight or impotence 

 Improving Medication Compliance Mnemonic : Informed Decision Activated Concerning Schizophrenia.  We should give Information before starting the medications. This should include the name, mechanism of action, effects, and side effects of the drugs.  The patient should actively take part in the decision , and he should actively discuss the information with the clinician.  At each visit, the clinician should ask the patient should if they have any CONCERNS or questions about the drug which he should address.  Family therapy for SCHIZOPHRENIA. 

Mental state findings: Mood: depression , mania, apathy Cognitions: cognitive decline  Thoughts: delusions Perceptions: hallucinations, cheifly visual .  Appearance and behavior : stupor  Conditions /Disorders: REM sleep behavior disorder  Sexual dysfunction  Mania Depression Delirium  Impulse control disorders

The following features suggest vascular dementia Patchy deficits Better free recall Fewer recall intrusions Early apathy Poor verbal fluency Vascular risk factors Relative preservation of personality Neurological signs e.g pseudobulbar palsy, brisk reflexes Erratic progression Signs of hypertension and arteriolocsclerosis on physical examination  The Hatchinski ischemic score is used to differentiate between the two. score above 6 suggests vascular dementia and below 5 suggestive dementia of Alzheimer type.

ADVOKATE: A Mnemonic Tool for Assessment of Eyewitness Evidence A tool for assessing eyewitness  ADVOKATE is a tool designed to assess eyewitness evidence and how much it is reliable. It requires the user to respond to several statements/questions. Forensic psychologists, police or investigative officer can do it. The mnemonic ADVOKATE stands for: A = amount of time under observation (event and act) D = distance from suspect V = visibility (night-day, lighting) O = obstruction to the view of the witness K = known or seen before when and where (suspect) A = any special reason for remembering the subject T = time-lapse (how long has it been since witness saw suspect) E = error or material discrepancy between the description given first or any subsequent accounts by a witness.  Working with suspects (college.police.uk)

Clozapine Induced Neutropenia It has a risk of 2.7% in patients on clozapine. Fifty percent occur in the first 18 months. The risk is dose-independent, idiosyncratic like neuroleptic malignant syndrome. Risk of agranulocytosis is with clozapine is 0.8%.   Risk factors:  Afro-Caribbean ethnicity, early age, low baseline WCC Mechanism:  the mechanism of neutropenia and agranulocytosis is unclear

Dementia: An Overview & Recent Advances in Management Prof. Arsalan Ahmad, Consultant Neurologist, Shifa International Hospital. The Institute of Psychiatry, Benazir Bhutto Hospital, hosted a lecture on “Dementia: An Overview & Recent Advances in Management”, on the fourth of August 2016. The guest speaker was Prof. Arsalan Ahmad, the Consultant Neurologist at Shifa International Hospital. The audience included psychologists and residents and consultants from both neurology and psychiatry. Prof. Fareed A. Minhas, Head of the Institute, set the stage for Prof. Arsalan’s lecture.  Part of our tradition, Prof. Minhas said, is to host these guest lectures. He alluded towards the overlap between psychiatry and neurology; many psychiatric patients present to neurologists and vice versa. Invariably, he said, a good evaluation would cause unveiling problems that require both neurological and psychiatric attention. He shared with the audience his satisfaction with the residents from the

Opioid use for pain management has dramatically increased, with little assessment of potential pathophysiological consequences for the primary pain condition. Here, a short course of morphine, starting 10 d after injury in male rats, paradoxically and remarkably doubled the duration of chronic constriction injury (CCI)-allodynia, months after morphine ceased. No such effect of opioids on neuropathic pain has previously been reported. Using pharmacologic and genetic approaches, we discovered that the initiation and maintenance of this multimonth prolongation of neuropathic pain was mediated by a previously unidentified mechanism for spinal cord and pain-namely, morphine-induced spinal NOD-like receptor protein 3 (NLRP3) inflammasomes and associated release of interleukin-1β (IL-1β). As spinal dorsal horn microglia expressed this signaling platform, these cells were selectively inhibited in vivo after transfection with a novel Designer Receptor Exclusively Activated by Designer Drugs (DR

The Institute of Psychiatry, Benazir Bhutto Hospital, World Health Organization Collaboration Centre, organised a Clinico-Pathological Conference (CPC), on the theme of Liaison Psychiatry, at the New Teaching Block, Rawalpindi Medical College, on the 27th of July 2016. The CPC sought to appraise the medical students, psychologists, and various physicians and surgeons in attendance, about the intricate relationship between the various disciplines of health care. The proceedings ensued, with Dr Yousaf Raza reciting from the Holy Qur’an and welcoming the attendees on behalf of the Institute. He introduced the audience to the layout of the presentations and the theme at hand. Dr Sundus Fatima, Academic Registrar at the Institute, then took the stage to present the first case history. She gave a detailed history of a 13-year-old girl who developed psychiatric complications as part of post-encephalitic sequelae; depressive and dissociative symptoms. In addition, she also had pica. She’d had