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Biomedical subjects

Uttom Chowdhury

Publications and source records attributed to Uttom Chowdhury.

7 recordsLinked to original sources

Autistic spectrum disorders. 1: Presentation and assessment.

As many as six in every 1000 children may be affected by an autistic spectrum disorder. Characterised by a triad of social communication difficulties, these children exhibit impairment in communication and socialisation, and restricted and repetitive interests, movements and activities. This article will discuss the distinction between autism, Asperger's syndrome and pervasive developmental disorder. Assessment should include a history of the child's development, observation, school report and a profile of the child's strengths and weaknesses. However, it is important that potential differential diagnoses as well as conditions associated with autism are also considered. Differential diagnoses, management and possible causes of autistic spectrum disorders will be discussed in more detail in next month's Clinical Updates.

Asperger Syndrome↗

Autistic spectrum disorders 2: diagnosis and management.

As many as six in every 1000 children may be affected by an autistic spectrum disorder. The previous article of this two-part series discussed the distinction between autism, Asperger's syndrome and pervasive developmental disorder, and examined the assessment process. This article looks at potential differential diagnoses that must be considered, as well as conditions associated with autism. Many theories about the causes of autism have been suggested, including the MMR vaccine. Recent research has suggested that there is no link between the vaccine and autism. There is no cure for autism, but intervention and management techniques should be aimed at educating parents and carers about the disorder and behavioural interventions to aid the child's skills development.

Antipsychotic Agents↗

Functional neuroimaging in early-onset anorexia nervosa.

Previous neuroimaging studies in early-onset anorexia nervosa provide evidence of limbic system dysfunction. The current study adds support to the possibility by revealing a significant association between unilateral reduction of blood flow in the temporal region and impaired visuospatial ability, impaired visual memory, and enhanced speed of information processing.

Adolescent↗

ADHD: assessment and intervention.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders of childhood. Although there is a lot of debate and controversy over the recognition of ADHD, it is generally accepted nowadays as a clinical disorder that may warrant treatment Children with ADHD are pervasively overactive, fidgety and disruptive. They have impaired attention and concentration and are impulsive. These symptoms have serious implications for the child's relationships with parents, siblings and peers. It is important that community practitioners, school nurses, health visitors and other health professionals are able to recognise the condition and be able to make an informed clinical assessment and refer and manage accordingly. The assessment should include a clear history from parents, a school report and an individual interview with the child. An assessment of parental management is essential to avoid the child being wrongly diagnosed with the condition. The successful intervention should be aimed at educating the child and family about the disorder and psychosocial interventions that may help the family and school cope with the child. In some cases introduction of medication may be necessary.

Adrenergic alpha-Agonists↗

The developmental, dimensional and diagnostic interview (3di): a novel computerized assessment for autism spectrum disorders.

OBJECTIVE: Autism is a diagnostic spectrum of variable severity, with significant comorbidity. No existing standardized interview measures autistic features dimensionally. The authors aimed to develop a parental autism interview that could be administered to unselected clinical and general population samples that measures both symptom intensity and comorbidity across the full range of the autistic spectrum. METHOD: A computerized procedure was devised for administration by trained interviewers that generates symptom and diagnostic profiles for both autism and non-autistic conditions. Test-retest reliability and interrater reliability were assessed in unselected clinical (n = 50) and nonclinical (n = 30) populations. Concurrent validity (n = 120), discriminant validity (n = 120), and criterion validity (n = 29) were evaluated in autistic spectrum and non-autistic patients. RESULTS: Test-retest and interrater reliabilities were excellent (most intraclass correlation coefficients > 0.9). Concurrent validity (agreement with independent clinician formulation) was very good (mean kappa = 0.74). Criterion validity, a comparison with the Autism Diagnostic Interview, was excellent. Discrimination between autistic spectrum versus non-autistic subjects was almost perfect (sensitivity 1.0; specificity > 0.97). CONCLUSIONS: The Developmental, Dimensional and Diagnostic Interview (3di) provides an efficient and accurate means of assessing, in dimensional terms, the presence of autistic symptoms in both clinical and normal populations. It offers novel opportunities for those engaged in research and clinical practice.

Autistic Disorder↗

Early-onset anorexia nervosa: is there evidence of limbic system imbalance?

OBJECTIVE: This study, part of a continuing effort to understand the pathophysiology of the brain in early-onset anorexia nervosa, attempts to validate findings from an earlier study of regional cerebral blood flow and to correlate any abnormalities in blood flow with eating disorder psychopathology. METHOD: Fifteen newly referred children and adolescents with a diagnosis of anorexia nervosa (AN) underwent regional cerebral blood flow (rCBF) examination using single-photon computerized tomography (SPECT) and the Eating Disorders Examination (EDE) for children. RESULTS: Mean age was 14 years 11 months (SD = 1.35). Mean weight for height ratio was 82.79 % (SD = 10.66). SPECT findings showed that 11 (73%) had asymmetry (hypoperfusion) of blood flow in at least one area. Regions of the brain showing hypoperfusion included the temporal lobe (n = 9), parietal lobe (n = 5), frontal lobe (n = 3), thalamus (n = 3), and the caudate nuclei (n = 1). The median EDE subscale scores were high for all four subscales. Those patients with hypoperfusion had higher median EDE subscale scores than those without hypoperfusion, although the differences were not statistically significant. CONCLUSIONS: Most patients in our study had abnormal rCBF, predominantly affecting the temporal lobe, confirming our previous findings. There was no association with the EDE scores. The findings support earlier suggestions of an imbalance in neural pathways or circuits, possibly within the limbic system. This hypothesis is considered within the context of current knowledge and suggestions made with regard to how it might be tested.

Adolescent↗