World Journal of Clinical Pharmacology, Microbiology and Toxicology

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https://imsear.searo.who.int/handle/123456789/162467

Chief Editor: Prof. Jorge Yanez Fernandez
ISSN: 2454-1729

Frequency: Quarterly

Language: English

Open Access Peer-reviewed journal

Web site: https://wjcpmt.com/index.html

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Now showing 1 - 20 of 32

Evaluation of the Hematologic Profile of Patients Undergoing Chemothera • who Make use of Hemato • oietic Rescue Workers.
(2015-11) Schwengber, Fernanda; Frizzo, Matias Nunes
Cytotoxic chemotherapy is directly linked hematologic changes during your anticancer treatment. The hematopoietic rescue agents can be used as supportive care for patients with anemia or neutropenia induced by cytotoxic chemotherapy. This study aimed to evaluate the blood count of patients undergoing chemotherapy and who made use of hematopoietic rescue workers, evaluating hematological changes induced by cytotoxic chemotherapy. This was a retrospective, descriptive and analytical study of the medical records of 36 patients undergoing chemotherapy and who used hematopoietic rescue workers at some time in their anticancer treatment in a High Complexity in Oncology Center. Of the patients included in the study population, 61% are female, and the average age of these is 57,25 years (SD ± 10,84), the most prevalent cancer among patients was the breast (48%), hematological used rescue agent is Filgrastim (53%), Erythropoietin (33%) and Erythropoietin and Filgrastim (144 The pharmacological class used in anticancer therapy in prevalence is the antimitotic taxoids and associations, representing 53% of the study population. The results of this study, as well as data from the scientific literature, demonstrate the importance of the use of hematopoietic rescue agents in chemotherapy protocols, due to the proliferative effect / therapeutic these growth factors, which reduce side effects of chemotherapy cytotoxic, giving cancer patients a better quality of life to follow your anticancer treatment, and thus increase the chance of cure.
Amenities that can Attract Skilled Birth Attendants (SBAs) to Practice in Rural Areas of a Developing Country.
(2015-11) Okafor, Innocent Igwebueze; Ugwu, Emmanuel Onyebuchi; Ndibuagu, Edmund Onyemaechi
The attainments of the Millennium Development Goal 5 (MDG 5) targets by 2015 in most developing countries are unlikely when large numbers of poor, illiterate, and vulnerable rural women do not have access to skilled care. To review progresses in MDG 5 targets and evaluate amenities that can influence SBAs to accept to practice in the rural areas of Enugu State. This was a questionnaire study administered to SBAs in private health facilities in Enugu metropolis from April 1 to 3o, 2014. Data on demographic profile and the amenities that can attract SBAs to live and practice in rural areas were extracted from the respondents. Out of 145 questionnaires administered 138 were completely filled, and analyzed using Excel 2007 software, and presented using percentages and figure. Majority of the SBAs were of ages between 20-30 years (69/138, 5o.0%). Staff nurse midwife were 91(65.9%) while medical doctor were 47(34.14 Ninety (65.2%) of the SBAs had no rural practice experience, and 7o (5o.7%) wish to practice in developed countries. The 5 top amenities that can attract SBAs to the rural area include: security of lives and property 134(97.a), pipe borne water supply 130(94.2%), equipped hospital 130(94.24 market with regular food supply 130(94.24 and higher staff salary and other motivations 129(93.54 There were high demands of amenities by SBAs for them to accept to live and practice their crucial services in the rural areas. The 5 top amenities that can attract SBAs to practice in the rural area include: security of lives and property, pipe borne water supply, equipped hospital, market with regular food supply, and higher staff salary and other motivations. SBAs services in the rural areas are crucial for attainments of the MDG 5 targets in developing countries by 2015.
Pharmacognostical and Phytochemical Studies on Barks of Moraceae Trees.
(2015-11) A., Venkatraman; Kumar, M. and Suresh
Bark is the outermost layers of stems and roots of woody plants. Plants with bark include trees, woody vines, and shrubs. Bark refers to all the tissues outside of the vascular cambium and is a nontechnical term. Products used by people that are derived from bark include: bark shingle siding and wall coverings, spices and other flavorings, tanbark for tannin, resin, latex, medicines, poisons, various hallucinogenic chemicals and cork. Bark has been used to make cloth, canoes, and ropes and used as a surface for paintings and map making. A number of plants are also grown for their attractive or interesting bark colorations and surface textures or their bark is used as landscape mulch. It serves as protection against damage from parasites, herbivorous animals and diseases, as well as dehydration and fire. Cork can containantiseptics like tannins, that protect against fungal and bacterial attacks that would cause decay. So we were very much interested to study the barks of moraceae family, they were Artocarpus heterophyllus Lam., Ficus bengalensis L., Ficus racemosa L., Ficus religiosa L. and Morus nigra L., The bark containing phytochemical compounds, pharmacognostical behavior and mycoflora were screened in this study.
Studies on the Mycoflora of Oil Cakes And characterization of Amylase.
(2015-11) V., Suresh; kumar, S. and Suresh
The role of oil cakes in maintaining soil beneficial biota and suppressing harmful pathogens is also widely recognized in different soil as well as different ecosystems. Annual growth in oil cake production is projected to average 2.3% annually over the decade to 2010. Oil cakes especially non-edible in nature are more viable option to meet this demand significantlyas edible oil cakes cannot be utilized for agriculture purposes . Utility of oil seed cakes are recognized in different spheres.In this studies concentrate the isolation and identification of mycoflora of Neem, Illupai, Coconut, Sesame and Groundnut oil cake and which biomass and amylase production characteristic features were carried out. Keywords: Mycoflora, Amylase.
Ethosomes as Novel Drug Delivery System: A Review.
(2015-11) Patrekar, Prasad V.; Inamdar, Suhel J.; Mali, Sachin S.; Mujib, Mulla T.; Ahir, Amita A.
The ethosomes are vesicular carrier comprise of hydroalcoholic or hydro/alcoholic/glycolic phospholipid in which the concentration of alcohols or their combination is relatively high. To provide continuous drug infusion through an intact skin, several transdermal therapeutic systems have been developed for topical application onto the intact skin surface to control the delivery of drug and its subsequent permeation through the skin tissue. Transdermal route is promising alternative to drug delivery for systemic effect. An attempt was made to formulate the highly efficient ethosomal drug delivery system and enalapril meleate is used as model drug. The following conclusion are drown from the result and discussion described in the previous chapter. Liposomal formulation was also prepared by the thin film hydration method. The techniques used were simple and reproducible. The prepared ethosomes were spherical and discrete in shape. The size of vesicles were found to be in the range of 3.26-5.79 tim,o.716-1.3o1 tim and 5.32 tim for unsonicated ethosomes, sonicated ethosomes and liposomes respectively. However ethosomes prepared by sonication method were more uniform and smaller in size, which is essential for skin permeation. While comparing the entrapment efficiency, ethosomes containing 3o% w/w ethanol and prepared by sonication showed highest value with respect to all other formulation, so it is concluded ethosomes prepared by sonication and containing 3o% w/w ethanol as the best formulation considering all other aspects. The highest value of transdermal flux for sonicated ethosomes containing 3o% w/w ethanol is the indication of complete and rapid penetration through the skin may be because of tiny vesicular size.
Assessment of the Pathogenicity Property of Fusarium • raminearum 1 in Balb/C Mice.
(2015-09) B, Kedar; G, Gemerlyn
An experiment was conducted to investigate the immunologic property, pathogenicity and treatment of Fusarium graminearum infection. Several groups of mice were randomly selected for the following groups: (PC, T1 and T2 were groups of mice that respectively received a 1:1, 1:100 and 1:100,000 fungal dilution while T3, T4, and T5 were groups of mice that respectively received the same concentration but each were treated with Diethylamine Acetarsol (Acetylarsan). A group of mice was included as a negative control (NC),In vitro assays were used to examine the ability of F. graminearum to produce enzymes, which are thought as important virulence indicators. Results revealed the ability of the pathogen to produce collagenase and elastase. In addition, histopathological examination indicated vascular congestion and mild triaditis of the liver. Pulmonary congestion and lymphoid hyperplasia in the spleen were noted. The fungi were recovered from the liver, lungs, spleen and skin of the legs of some experimental animals. Likewise, increase in weight of the spleen doubled as early as the second week (from 49 mg to 80 mg) and progressed up to the fourth week (125 mg) where it tapered off in the untreated group. Similar increase in the weight of the spleen was observed in the treated group (40 mg to 64 mg) but not as great as that in the untreated group (105 mg). Hematological findings showed a lymphocytic count of 1.83 that increased to 3.356, monocyte count of 0.47 that increased to 0.981 and neutrophils increased from 0.399 to 1.698 in untreated groups. Lymphocyte count in the treated group was increased from 1.8 to 3.64, monocytes increased from 0.068 to 0.325 and neutrophils increased from 0.223 to 1.056. High incidence of death was observed in animals that did not receive treatment (PC, T1, and T2) while relatively lower death incidences were exhibited by groups that received diethylamine acetarsol (T3, T4 and T5).
Clinical Epidemiological Investigation of Moldy Grain and Fodder Poisoning in Goat in Kathmandu Valley.
(2015-09) Karki, Kedar
An outbreak of a syndrome of unknown etiology associated with the feeding of moldy maize grain and green fodder to goat in a herd of male 3853 goats for sale for the Dashahara festival during the month of October-2010 in Kathmandu valley. In a period of 10 days 500 goats suddenly became ill with symptoms of anorexia, apathy, diarrhea and ruminal stasis .On clinical examination these goats were provisionally diagnosed with sudden illness and moldy corn/fodder poisoning was suspected., about 250 goats died. Necrosis of the fore stomach mucosa was the most characteristic gross pathological change. Clinical pathological findings included mild focal erosions to severe, diffuse, coagulative necrosis of the mucosa in the rumen, reticulum and omasum and congestion and hemorrhages in the abomasums. Liver with shrunken appearance and pale to yellowish discoloration with bile filled distended bladder, pin point hemorrhage in kidney, intestine with excessive mucus. On mycological and microbiological examination of tissue samples from post-mortem of dead goat on respective medium revealed the growth of fungal pathogens like Penicillium spp with Staphylococcus.. These results provide circumstantial evidence that feeding on moldy maize grain and green fodder leaves infested with Penicillium may cause outbreaks of systemic Mycosis in goats.
Clinical evaluation of the efficacy of kshara karma with Apamarga kshara and Jatyadi taila pichu in the Management of Cervical Erosion (Karnini Yonivyapada).
(2015-09) Gupta, Pragya; Sharma, Sushila
Cervical erosion is one of the commonest gynecological diseases which includes large section of women among her reproductive age group and needs medical attention and non surgical treatment In modern system its treatment done with diathermy and cryosurgery which has various side effect like cervical stenosis, accidental burns, etc. In Ayurveda science treatment of karnini yonivyapada by kaphahara chikitsa with Apamarga kshara which have property of lekhana, sodhana, ropana, stambhana, kaphghna and so many properties and Jatyadi taila which have property of vatashamak ,sheshmhara, mansapkarshana, shodhana and ropana . All these properties facilitate destruction of columnar epithelium and facilitate the re-epithelization of new healthy stratified squamous epithelium on ectocervix with this entire basis, this research work was done. karnini yonivyapada described in ayurvedic text books can be correlated with cervical erosion. Apamarga kshara ( Sushruta Samhita Sutrasthana-11/5) and Jatyadi taila ( Bhava Prakash Madhyama Khand.- 47/90-95) . Group I- this group 15 registered patients were administered with application of 'Apamarga kshara' on cervix and 'Jatyadi Taila' Pichu in the vagina for 7 sitting alternate day in a month Group II- In this group 15 registered patients of Cervical erosion were administered with 'Jatyadi Taila ' Pichu in the vagina daily for 14 days in a month. Treatment was done after bleeding phase of menstrual cycles over. Overall percentage relief was higher in group I 72.17% followed by group II i.e. 68.44% . Statistically the results were highly significant (p<0.001) in both groups. Combined use of kshara karma and Jatyadi taila pichu (Group I) is more effectively helps in managing the disease cervical erosion.
Formulation and Evaluation of Nanoparticles as Sustained Release Topical Formulation Containing Non-Steroidal Anti -Inflammatory Drug.
(2015-09) M H, Abitha; Mathew, Flowerlet
The objective of this work is to prepare flurbiprofen nanoparticles, and then incorporated into the freshly prepared gels for transdermal delivery, providing controlled release of the drug, reducing the oral side effects of the drug and for enhancing stability. Flurbiprofen is a non-steroidal anti-inflammatory drug used to treat gout osteoarthritis, rheumatoid arthritis, and sunburn. In this study Flurbiprofen nanoparticles are prepared by nanoprecipitation method. A total of 8 batches are prepared by using polymers such as ethyl cellulose, Eudragit L100 and are evaluated for various parameters. Drug-excipients compatibility was performed by FTIR study. Optimized batch of nanoparticles F3 was further formulated as gel for topical delivery. A total of 4 batches of gel were prepared using different concentrations of carbopol 934. Prepared gel formulations are evaluated for physical parameters and in vitro drug permeation study. The in-vitro release rate of gel preparations was evaluated by diffusion cell method using cellophane membrane with phosphate buffer pH Z4 as the receptor medium. F3-G1 showed highest in-vitro release rate and superior physicochemical properties. These formulations were evaluated for ex-vivo permeation study through chicken skin using Franz diffusion cell. The drug release data of optimized batch were fitted into different kinetic models which show that the drug release from gel formulations follow zero order release. The overall studies concluded that the F3-G1 Flurbiprofen nanoparticle gel can be effectively used for the treatment of chronic conditions of rheumatoid arthritis, osteoarthritis.
Microbial Analysis of Majoone Falasifa (A Compound Herbal Formulation).
(2015-09) Mohd., Peerzada; Rahman, Khaleequr; Rashid, Basharat; Rani, Seema
Majoone Falasifa (MF) is a polyherbal sugar based semisolid preparation used in Unani medicine to treat neurological, digestive, urinary and various chronic and debilitating disorders especially in geriatric care. This Unani compound formulation contains thirteen ingredients viz; Emlica Officinalis, Matricaria Chamomillia, Cinnamomum Zeylanicum, Piper Longum, Piper Nigrum, Pinus Gerardiana, Cocus Nucifera, Vitis Vinifera, Terminalia Bellirica, Orchis Latifolia, Plumbago Zeylanica, Zingiber Officinalis nd Aristolochia Indica. Though used since ancient time its microbial analysis was not carried out till date. Therefore in present study microbial analysis of Majoone Falasifa was evaluated under the accelerated testing conditions.
Study on Physico-Chemical Analysis of Heavily Polluted Shivaji Talao and Its Impact On Aquatic Bodies.
(2015-09) Muralidharan, Leena; Oza, Archana
Physicochemical characteristics of Shivaji talao was conducted to analyze ecological parameters like pH, CO2, 02,total hardness, salinity, phosphate, turbidity of water. The study revealed that pHvaluewas 8.5and it was same a year before, while dissolved oxygen was 0.67 mg/1 .Carbondioxide contend salinity, phosphate ,turbidity and total hardness level increased .Study showed that water was not found to be suitable for aquatic animals due to high salinity content in the water.
Hemorrhagic Proliferative Proventriculitis and Gizzard Erosion in Poultry Birds.
(2015-09) Karki, Kedar
A new disease condition has emerged affecting replacement pullets. It affects the birdsbetween 2 to 10 weeks of age. The mortality rate varies between 1 to 10% and ultimately the flock is left with creation of several small poorly feathered and pale chicks. Though it has not been possible to establish the exact cause of this condition, following three points has been taken in consideration. HPPGE is an illness that involves one or more infectious agents. The digestive tract and endocrine organs may be primary targets for this agents.The spectrum of signs or lesions are either caused by or exacerbated by nutritional, husbandry and hygienic factors. The response to the treatment is often poor but the symptomatic treatment has helped in ameliorating the mortality. Similar condition has been widely reported in broilers under various names like Malabsorption syndrome, infectious Proventriculitis, infectious runting syndrome, pale bird syndrome and stunting syndrome.
DIVA Vaccines: A Brief Review on its Novel Facets for the Eradication of Infections of Livestock and Poultry.
(2015-09) Ganguly, Subha; Padhy, Arpita; Para, Parveez Ahmad; Pandey, Arvind Kumar; Praveen, Praveen Kumar; Wakchaure, Rajesh; Sahu, AmitRanjan
DIVA vaccines also known as Differentiating Infected from Vaccinated Animals help in the differentiation between infected and vaccinated animals. The first DIVA vaccines were known as marker vaccines. The term DIVA vaccine was coined in 1999 and the accompanying diagnostic tests were developed by J.T. van Oirschot and colleagues at the Central Veterinary Institute in Lelystad, The Netherlands [1], [2].
Introduction of Electrophoresis Process.
(2015-09) Kheyrodin, Hamid
Electrophoresis is the process of moving charged molecules in solution by applying an electric field across the mixture. Electrophoresis is often classified according to the presence or absence of a solid supporting medium or matrix through which the charged molecules move in the electrophoretic system. The fundamental driving force of electrophoresis is the voltage applied to the system. Gel electrophoresis is a laboratory method used for a variety of protocols including sequencing, RFLP analysis, marker analysis, DNA fingerprinting and DNA purification. It is based on two key principles: 1) DNA has an overall negative charge (due to the phosphate backbone) and thus will migrate towards a positive charge. 2) A gel acts as a sort of microscopic sieve; smaller DNA fragments will travel through the gel more rapidly than larger fragments. Thus DNA can be separated based on the length (size) of the DNA segment In this study we worked in Desert laboratory in semnan university for analysis effect of temperature on gle electrophoresis. We conducted that method of electrophoresis used to separate proteins or nucleic acids (DNA and RNA) across a temperature at 4°C for 10-15 minutes. poured gel at 4°C for 10-15 minutes OR let sit at room temperature for 20-30 minutes, until it has completely solidified.
Recent Advances in Topical Gel Formulation.
(2015-09) M H, Abitha; Mathew, Flowerlet
Transdermal drug delivery systems are a constant source of interest because of the benefits that they afford in overcoming many drawbacks associated with other modes of drug delivery (i.e. oral, intravenous). Topical gels are becoming more popular due to ease of application and better precutaneous absorption. Gels are semisolid formulations, which have an external solvent phase, may be hydrophobic or hydrophilic in nature, and are immobilized within the spaces of a three-dimensional network structure. Gel formulations provide better application property and stability in comparison to cream and ointments. Skin is one of the most extensive and readily accessible organs on human body for topical administration and is main route of topical drug delivery system. Topical gels are intended for skin application or to certain mucosal surfaces for local action or percutaneous penetration of medicament or for their emollient or protective action. Recent studies have reported other types of gels for dermal drug application, such as proniosomal gels, emulgels, bigels and aerogels. This review is concern with all detail information regarding novel approaches to topical gel formulation, advantages and classification of gel.
Near Fatal Accidental Organophosphate and Phosphine Poisoning Of a Family of Eight: Case Report.
(2015-07) Ojeniyi, Durodola Adewumi; Adewunmi, AfinowiIdowu; Olusayo, Amole Isaac
We describe a near fatal poisoning in a family of eight caused by accidental ingestion of Aluminium Phosphide (A1P) and Dichlorvos (DDVP), common and readily available pesticides used to kill rodents and insects in stored farm products. Management challenges in a rural hospital, where most accidental agricultural based poisoning cases are likely to present are also discussed.
Effect of Weed Interference on Performance of Grain Corn (Zea mays L.) At Different Plant Densities.
(2015-07) Dehghamian, Hasan; Tahmasebpour, Behnam
In order to evaluate the effect of weed interference and plant density on performance of grain corn, an experiment was carried out as split-plot based on randomized completed bloke design (RCBD) with three replications at the Agriculture Research Station, University of Tabriz, Iran in 2009. Plant density levels including: 5, 7, 10 and 16 plant/m-2 was allocated to the main plots and weed interference at three levels including: weed free (w1), once in a row weed interference (w2) and perfect weed interference (w3) were assigned to subplots. The results showed that weed interference on grain yield, 1000 seed weight kernel weight and number of ear had a significant effect. With increasing of natural weed interference during growth period, grain yield, 1000 seed weight, kernel weight and number of ear decreased. Also, interaction between weed interference and plant density was significant in kernel weight of ear. Between different densities the greatest grain yield with 1020 g/m-2 obtained from 16 plant/m-2 and weed free treatment Weeds in treatments of once in a row weed interference 50 percent and treatments of perfect weed interference in long of growth period 75 percent grain yield decreased. Results showed that with increasing plant density, corn can increase its competitiveness with natural weeds of field increased the grain yield. Generally, the results indicate that the sensitivity to weeds interference especially in low plant density due to the effect of early competitive start may influence extremely the yield of maize.
Formulation and Evaluation Of Gastroretentive Losartan Floating Tablets.
(2015-07) C, Madhavi; Y, Ramesh; K, Sankar Rao; A, Deepthi; K, Gnana Prakash; M, Gobinath
The objective of this research was to formulate and evaluate hydrodynamically balanced controlled drug delivery system of Losartan. This dosage form is associated with many advantages especially increased bioavailability and reduction in dosing frequency. The formulation was designed adopting optimization technique, which helps in setting up experiments in such a manner that the information is obtained as efficiently and precisely as possible. Initially, considering buoyancy as the main criteria, blank tablets were compressed for different formulae with various polymers like HPMC, MC and EC. The formula selected for design had a combination of Losartan, HPMC, EC and MC. The tablets were prepared by direct compression method and evaluated for Losartan content in vitro release profile and buoyancy. The dissolution study was carried out in simulated gastric fluid using USP dissolution test apparatus employing paddle stirrer. Duration of buoyancy was observed simultaneously when the dissolution has carried out The variation in weight was within the range of ±4% complying with pharmacopoeial specifications (±Z5%). The drug content of Losartan floating tablet 8.455±0.0085 mg in of optimized formulations indicating content uniformity. The buoyancy of the tablets was range 15.345±0.1321 hrs the maximum buoyancy was seen in P6, which has a high level of drug to polymer ratio. The in-vitro release was found to be in the range between the 79.12% to 90.45%.. The formulation P6 has an in vitro release of 79.12% showed the release of the drug in the controlled manner. The optimized formulation P6 exhibited responses that were comparable with that of the predicted values of the design in optimization technique. This indicates the suitability of the technique chosen for the present dosage form.
High level of MRSA colonization in health care worker: alarm to implement health care policy.
(2015-07) Kogekar, S.P.; Jain, Khyati; Kumari, Priyanka; Chavan, Nilesh; Peshattiwar, Prashant; Rajput, Madhurendra S
The aim of the study was to investigate probable carrier rate of the healthcare workers and screened for carriers of MRSA as they could pose a potential risk factor for nosocomial transmission when the same carrier are exposed to the hospital setting during their clinical postings. A total of 100 nasal swabs were collected from the nursing staff and doctors. Sterile cotton swabs moistened with glucose broth were used for sample collection. Swabs were cultured on to nutrient agar, blood agar, and mannitol salt agar, incubated at 35 °C for 48 hrs. Staphylococcus aureus was identified by standard methods according to CLSI guidelines. Methicillin resistance was detected by using cefoxitin disc 30pgm on Mueller Hinton agar with 4% NaCL Of the 100 samples screened 30(30%) strains of Staphylococcus aureus were isolated, out of which 16 (53.33%) were Methicillin resistant Staphylococcus aureus (MRSA) and 14 (46.66%) were methicillin sensitive Staphylococcus aureus (MSSA). The overall carriage rate of methicillin resistant Staphylococcus aureus in our study was 16% with the highest rate being seen among the nursing staff (19.35%) and clinical staff carriage rate was lesser (10.52%) as compared to the nursing staff. Chest department samples showed higher carriage rate (33.33%) followed by pediatrics department (28.57%). The present study revealed that HCWs who have contact with patients are at risk of acquisition and colonization with antimicrobial resistant bacteria especially MRSA. Transient hand colonization is the primary mean of cross transmission. Simply education of HCWs on hygienic measures especially proper hand wash is the key to overcome MRSA infection in ICUs.
Autism Spectrum Disorder: Lost In Space.
(2015-07) Chidananda, K.N; K, Jagadeesh
Pervasive developmental disorders (PDD) is a developmental neurological disorders. PDD consist of Autism, Asperger syndrome, Pervasive developmental disorder not otherwise specified Rett's disorder and childhood di sintegrative disorder. The incidence of the disease has been increased in past one decade when compared to earlier, which is due to increased awareness of the disease. The diagnosis of the PDD mainly by diagnostic and statistical manual of mental disorder(DSM) published by American psychiatric association. DSM V the pervasive development disorders were considered into single autism like spectrum of disorders. Autism spectrum disorder is not completely curable and hence requires lifelong management Educational and behavioral interventions are more successful when compared to medications alone. Early interventions have more positive results. The present review articles describes regarding the Pervasive developmental disorders, prevalence of autism worldwide, individual countries ,their characteristic features, diagnosis by DSM IV and DSM V, causative factors involved and management.

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