India New projects,business opportunities in India,business in India,new business opportunities,investment opportunities in India,sales leads,Business leads/. Home › Articles › Digest Of Important Judgements On Transfer Pricing, International Tax And Domestic Tax (Jan To March 2017). ![]() Wipro selected as a strategic partner for Data Center Services by innogy. Frankfurt, Germany & Bangalore, India - September 15th, 2017. Read more. Sophisticated content for financial advisors around investment strategies, industry trends, and advisor education.FREE PAPERS (ORAL)Amlan Kusum Jana*1, Neelanjana Paul. Sujit Sarkhel. 3, Samir Kumar Praharaj. ![]() ![]() Debasish Sanyal. 51. KPC Medical College, Kolkata, India, moc. ICARE Institute of Medical Sciences & Research, Haldia, India, moc. Institute of Psychiatry, Kolkata, India, moc. Kasturba Medical College, Manipal, India, ni. KPC Medical College, Kolkata, India, moc. Keyword: Renal transplantation, psychiatric comorbidity, legal issues. Introduction: Renal transplantation (RT) is an accepted mode of treatment of end stage renal disease (ESRD), providing a favorable outcome both in renal function as well as quality of life. There is a bidirectional interaction between Psychiatry and RT. ESRD itself may cause various behavioral disturbances. Transplantation is a potential source of stress, in the donor due to organ loss, who is also a relative of patient, in most cases. There are psychosocial issues like restrictions in lifestyle after transplantation, cost, and vocational changes. Moreover, use of steroids and other immunosuppresants after RT may directly cause psychiatric comorbidity. Psychiatric comorbidities have been described in other modes of transplantation as well. However, the sheer volume of patients in RT is higher, making it more relevant than others for studies on comorbidities. Psychiatric co- morbidities in renal transplantation in RT can arise out of stress of the procedure, change of lifestyle, introduction of new medications, or from their combinations. Depression and anxiety are the commonest, though psychosis is not rare. Symptoms are often precipitated or worsened by complications of illness e. Quality of life generally improve from pre RT level but worsens with onset of psychiatric illnesses. Treatment of psychiatric disorders in transplantation recipients is a therapeutic challenge. Many psychotropic drugs are unsuitable for use in renal impairment. Changes in pharmacokinetics, with reduced capacity of patients to excrete drugs and their metabolites, has to be considered along with possible interactions of psychotropics with other drugs that he may be receiving. It is also interesting to discuss as to what extent treatment of psychiatric disorders can alter outcome of transplantation. Legal issues: There is controversy in RT about legality of related and unrelated donors, with most states in India disallowing unrelated donors, except West Bengal. Another pertinent issue is cadaveric transplantation, which is being conducted nowadays though not very commonly. Research status and future directions: There is lack of research in psychiatry in this population. There are methodological difficulties in assessing psychiatric co- morbidities, though qualitative and quantitative research is being undertaken in some multi- disciplinary, tertiary hospitals in our country.
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