13-May-2014 Somita Pal & Little Yadav MUMBAI : A 42-year-old HIV positive patient suffering from TB of the brain went on the rampage at Bombay Hospital on Monday, killing a 65-year-old lung cancer patient and injuring two others. The Agripada resident was admitted on May 8 after he tested positive for HIV. He was also suffering from a psychiatric problem, but the hospital denied the charge. In an unprovoked attack around 6.30am, the patient started hitting Lilabihari Govardhan Thakur, 65, who was sleeping on the adjacent bed, with a saline rod till he started bleeding. He also injured two other patients - Praful Parmar, 70, and Janardhan Arte, 66 - and a ward boy. "There were 30 patients in the ward on the third floor when the incident took place. The medical staff swung into action with a rope and sedative injection to restrain the patient. He was brought under control by four ward boys and five nurses after 15 minutes," said a doctor with Bombay Hospital. The police later arrested the patient and booked him for murder. Thakur was shifted to the ICU, but he passed away four hours later. "He had a severe skull fracture. We tried reviving him, but he succumbed to his injuries. His body has been sent to JJ Hospital for post-mortem," said Bombay Hospital spokesperson Dr Sagar Sakle. Sources said the attacker suffered from psychiatric problems and had homicidal tendencies. Before he was admitted to Bombay Hospital, he underwent treatment at Mazgaon's Masina Hospital. JJ Hospital dean Dr Tatyarao Lahane also confirmed to dna that the patient had a history of mental illness and was treated for the same a few years ago. But Dr Sakle said: "The patient had no psychiatric problem and that was the reason he was not referred to a psychiatric." Neurologist Dr Nirmal Surya of Bombay Hospital who was treating the patient told dna: "He was not under any medication. He had TB of the brain a year-and-a-half ago, but he stopped taking medicines midway. An MRI scan detected swelling in his brain, but he showed no signs of violence or aggression in the last four days." The patient was kept in the ward till he was arrested. He was later shifted to JJ Hospital where he is kept under observation in the psychiatry ward. The doctor treating him at JJ told dna that he suffers from chronic psychiatric ailment. "He was on anti-psychotic medicines which he had stopped taking," he said. The complainant, nurse Alina Anthony, told the police, that the hospital staff forced him to a chair and restrained him from moving after the violence erupted. Senior inspector Narendra Singh of the Azad Maidan police station said initially, a case of attempt to murder and voluntarily causing hurt with use of sharp weapon was registered against the accused. "However, after the cancer patient passed away, a case of murder was also registered," he said. The deceased, Thakur, was a resident of Pratiksha Nagar in Sion. "My father was shifted to the general ward from the ICU on April 30. His bed was next to that of the accused. My mother had gone down to buy medicines when my father was attacked," said Pankaj, Thakur's son. Eyewitnesses said the accused unscrewed the rod of the IV drip and first attacked Pankaj's father with the rod thrice before making the others his target. Psychiatrists said such incidents should not deter private hospitals from admitting patients with mental illnesses. Noted psychiatrist Dr Harish Shetty said: "Private hospitals should start a ward dedicated to mental illness. This incident could have been avoided if Bombay Hospital had such a ward." He said most doctors were not familiar with mental illnesses. "Some years ago, a patient committed suicide in a private hospital and since then, its management stopped admitting patients with mental illnesses. The awareness about mental illness is very low even in the medical fraternity," he said. http://www.dnaindia.com/mumbai/report-tb-patient-goes-on-the-rampage-kills-one-injures-three-in-bombay-hospital-1987698
Suspected schizophrenic attacker of cancer patient in JJ psychiatry ward Sumitra Deb Roy & Malathy Iyer MUMBAI: The 42-year-old patient who attacked others in Bombay Hospital is likely to undergo intensive psychiatric treatment on a priority basis at the state-run JJ Hospital because doctors there claimed he had a history of mental illness. "We found out that he was under treatment for schizophrenia until six years ago. He has been suffering from seizures as well for the last two years,'' said Dr T P Lahane, the dean of the JJ Group of Hospitals. The patient, who cannot be named because of his HIV-positive status, also suffers from diabetes, tuberculosis and has impaired kidney function. The JJ team will determine whether his impaired mental status led to his violent spree that ended in the death of a cancer patient. "He is in the psychiatry ward, and we are carrying out diagnostic tests to determine all his health problems. We will then start his complete treatment," added Dr Lahane. The JJ doctors are also trying to establish if he has lesions in his brain. It appears the attacker has been under treatment of various doctors over the last few years. He was in a private hospital in Byculla, but left 10 days ago because his "headaches refused to cease". "He was treated for brain tuberculosis last year, but didn't follow up until a few days back," said Dr Sagar Sakhle, Bombay Hospital spokesperson. This time around, he was admitted under neurologist Dr Nirmal Surya. The hospital did not seem to be aware of his mental illness. "We were still in the process of investigating his various illnesses," said Dr Surya. On Sunday morning, he underwent a procedure to collect cerebrospinal fluid for further investigations. "He was most cooperative with our technicians at that time," he added. After the early morning mayhem on Monday, the doctors learnt that the attacker's 'headaches' were so severe he would bang his head against the bedstead. Dr Surya said it's possible his HIV condition was so advanced that he had developed HIV encephalopathy, a bunch of neurological disorders. Medical textbooks say that HIV encephalopathy begins with intellectual decline and forgetfulness and degenerates into progressive decline in memory, and psychosis. http://timesofindia.indiatimes.com/city/mumbai/Suspected-schizophrenic-attacker-of-cancer-patient-in-JJ-psychiatry-ward/articleshow/35031990.cms? Negligence shown to mental illness and its patients responsible Sudhir Shetty MUMBAI : The Bombay Hospital incident, in which an HIV+ patient suffering from brain TB killed another patient and injured two, is a sharp reminder of the negligence shown to mental illness and its patients, especially if they are suffering from chronic ailments, even by the medical fraternity. Dr Yusuf Matcheswalla, a psychiatrist attached with Masina hospital, said: "The problem with treatment of chronic ailments is that specialists are so busy trying to diagnose the patient with respect to their area of expertise (ie a chest physician focussing on TB) that they forget s/he can also have mental illness and be on the verge of a nervous breakdown. Abroad, chronic patients are mandatorily referred to a psychiatrist." A similar incident happened in Sewri TB hospital on February 12, when a 40-year-old multi-drug-resistant TB (MDR-TB) patient attacked a ward boy and other patients with knife. This was followed by a teenaged TB patient ending his life. An ailment like tuberculosis often ends up isolating the patient socially, say doctors. The absence of support from friends and relatives, coupled with physiological and mental side effects of the disease, has made it a thumb rule for doctors to advice psychiatric counselling for these patients. Dr Jaising Phadtare, professor of pulmonary disease and intensivist at Grant Medical College, admits to the need for robust counselling for patients, especially during the first three months of treatment, for MDR-TB. "The doctor has to counsel the patient and make him/her understand the basics of medicine and its effects. For instance, the doctor must explain the need to take a particular drug at a certain time..." said Phadtare. "Helping build the patient's confidence in the initial three months of treatment can go a long way for the next couple of years of treatment." Agreeing with Phadtare, Dr Nagsen Ramraje, head of chest medicine department at Sir JJ Group of Hospitals, said the prolonged course of treatment makes the patient anxious. "The anxiety is coupled with social stigma and insecurity about the future. Also, side effects of the drugs precipitate depression," said Ramraje. Doctors also feel that a few things in the TB control programme need to be changed. A second-line drug, cyclocerine, is known to induce psychosis and, hence, doctors say an alternative tericox, which has fewer side effects, must be included in the programme. http://www.dnaindia.com/mumbai/report-negligence-shown-to-mental-illness-and-its-patients-responsible-1987674 -- -- You received this message because you are subscribed to the Google Groups "Mental Health Advocacy (News 'N Views) India" group. 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