bluuebunny/crossref_metadata_2025 huggingface dataset:
Storytelling in Medical Education, Clinical Care, and Clinician Well-Being
Authors: Ingram Cory
Published: May 2023

We all share our lived experiences with others through stories. Sometimes we may share a story in conversation over a cup of coffee or simply share a photograph with a friend to illustrate an event in our life. During our health care training we can learn concepts through reading textbooks, medical articles, and informational lectures. However, it is often the real-life stories that teach the lessons, so it is best understood, remembered, and applied. This actionable knowledge is created through patients, family members, and/or clinicians sharing their stories. When learners are able to acknowledge, absorb, interpret, and act on the stories of others they are practicing narrative medicine. Storytelling bridges the worlds of patients, families, clinicians, health systems, policy makers, communities, cultures, and traditions to help us find common understanding to create experiences that match our expectations and improve the lived experience of giving and getting patient centered healthcare. This paper reviews the literature on storytelling as a methodology that lends a rich opportunity for meaningful academic productivity in research, community engagement, and quality and safety improvement. I close the paper with a sincere invitation to explore a specially crafted storytelling workshop to train patients to craft their stories of receiving health care to share with intentionality, confidence, and emotional wellness with medical audiences to improve the delivery of patient centered care; to improve the delivery of narrative medicine.
Trichilemmal Carcinoma of the Scalp
Authors: Shetty Archana , Muralidhar Aparna , Gaffoor Nidha
Published: May 2023

Trichilemmal carcinoma (TC) is a rare malignant adnexal neoplasm, falling under the umbrella of tumors with follicular differentiation generally presenting as papulonodular growth with surface ulceration over sun-exposed skin. Histologically, it mimics tumors such as basal cell carcinoma, sebaceous carcinoma, squamous cell carcinoma, and malignant proliferating trichilemmal tumors. As there is a difference of opinion regarding the histopathological criteria for TC, a definitive diagnosis should be confined to cases having the majority of histomorphological findings with immunohistochemical corroboration to help define the clinicopathological behavior of this disease. Rarity, indolent clinical course in spite of local aggressiveness and a good survival rate postexcision further undermine the importance of this unique entity.
Study on risk of hypercoagulation in patients with obstructive sleep apnea
Authors: Omar Amany , Elfadl Abd-Elazim Abo , Ahmed Yousef , Mahmoud Marwa A.
Published: May 2023

Background

Studies propose that lack of oxygen in the blood experienced by patients with obstructive sleep apnea (OSA) during sleep leads to the liberation of several inflammatory mediators that modify the blood and produce hypercoagulable status.

Objective

The objective of this research was to evaluate the risk of hypercoagulability in individuals with OSA.

Patients and methods

The current study was conducted as a case–control study during the period from January 2018 to July 2019 at Assiut University Hospital. Markers measured for assessing the risk of hypercoagulability in OSA were red cell distribution width, mean platelet volume, platelet distribution width (PDW), and platelet count (PC).

Results

Our findings indicate a statistically significant difference between patients with OSA and healthy controls regarding red cell distribution width, mean platelet volume, PDW, and PC. However, there was no significant difference between patients with moderate and severe degree of OSA regarding these indices. A positive statistically significant correlation of apnea/hypopnea index was found with PC and PDW.

Conclusion

Our results suggest that patients with OSA are risky for hypercoagulability; however, further larger studies are required to confirm this conclusion.
Value of oxidative stress biomarkers in patients with obstructive sleep apnea
Authors: Mohamed Nezar R. , Shaaban Lamiaa H. , Abd El Hakim Mohamed A.E. , Refaat Hadeer E.E. , Saeed Zainab H.
Published: May 2023

Background

A few investigations have recommended that obstructive sleep apnea (OSA) is related with expanded degrees of oxidative pressure markers or decreased antioxidant defense. The aim of this study was to assess the value of oxidative pressure biomarkers in OSA and correlate their levels with disease severity.

Patients and methods

This case–control study was carried out on 35 patients with OSA recruited from Minia University Hospital in the period from August 2018 to August 2019. The study was approved by the hospital research committee of Minia University. All patients gave informed consent. Complete history, Epworth sleepiness score, STOP-BANG score, pulmonary function tests, and arterial blood gas oxidative stress biomarkers such as thioredoxin, superoxide dismutase, malondialdehyde, C-receptive protein, and erythrocyte sedimentation rate were done.

Results

All oxidative stress markers were significantly elevated in the case group, and there was a good correlation between all of them and polysomnography results such as apnea/hypopnea index, RDI, minimal oxygen saturation, number of desaturations less than 90, and oxygen desaturation index.

Conclusion

There was a rise in all oxidative stress markers in the case group versus the control group.
Coronavirus disease 2019 pandemic
Authors: Tag Eldin Mohamed Awad , Elassal Gehan Mohamed , Tag Eldin Amr Awad , Ahmed Noha Othman
Published: May 2023

The coronavirus disease 2019 pandemic is an evolving pandemic caused by severe acute respiratory syndrome coronavirus 2. The disease was first recognized in Wuhan, China, in December 2019. It was announced as an International Public Health Emergency in January 2020, and as a pandemic in March 2020. By reaching October 2020, more than 34.6 million cases along with 1.02 million deaths have been declared worldwide. The virus is of zoonotic origin and spreads most often when people are in close contact via small droplets or via contaminated surfaces. Common symptoms are mostly fever and respiratory symptoms and might be complicated by pneumonia and ARDS. Preventive measures include hand hygiene, social distancing, wearing a face mask in public, and self-isolation for suspected cases. Authorities worldwide implemented travel restrictions, lockdowns, screening, and contact tracing to slow the spread of the disease. These policies led to global social and economic burden, and up to 100 million people have fallen into extreme poverty.
Intraoperative pulmonary re-expansion edema complicating pulmonary decortication for tuberculous pleural effusion
Authors: Issoufou Ibrahim , Ouadnouni Yassine , Sani Rachid , Smahi Mohamed
Published: May 2023

Pulmonary re-expansion edema (PRE) was first described by Carlston in 1958. To the knowledge, only one case has been described following pleuropulmonary decortication. The authors present the case of a 19-year-old patient who underwent pleuropulmonary decortication and who presented an PRE intraoperatively. Early diagnosis and the rapidity of treatment allowed a favourable evolution. Therefore, the prognosis of intraoperative PRE depends on the rapidity and efficiency of medical management.
Assessment of serum levels of adiponectin and resistin in adult patients with asthma
Authors: Hosny Salwa S. , Farres Mohamed N. , Melek Nermine A. , Kamal Sylvia T. , El Najjar Marwa R. , Abou El Fotoh Radwa H. , Abd ElGwad Asmaa M. , Elmahdi Amira R.
Published: May 2023

Introduction

The mechanisms connecting obesity and asthma are complex. Mechanical and inflammatory factors have been proposed. Adipose tissues secrete various adipokines. Some are proinflammatory such as resistin, whereas others are anti-inflammatory such as adiponectin. We aimed to assess the serum levels of adiponectin and resistin in patients with asthma and correlate them with asthma control and severity as well as obesity parameters of the participants.

Patients and methods

This case–control study included 64 patients with asthma and 24 healthy controls. They were all subjected to anthropometric measurements, asthma control test, pulmonary function tests, skin prick test, and total serum immunoglobulin E levels. Serum adiponectin and resistin concentrations were measured.

Results

Adiponectin and resistin levels were significantly higher among patients with asthma than controls (P<0.001). Serum resistin levels were significantly higher in obese patients with asthma than nonobese (P<0.001), whereas adiponectin levels were not different between the two subgroups. Serum adiponectin level was positively correlated with the duration of asthma, forced expiratory volume in 1 s /forced vital capacity ratio, and resistin level, whereas resistin level was positively correlated with age, sex, and body fat percentage. Resistin/adiponectin ratio was positively correlated with body fat percentage.

Conclusion

Adiponectin and resistin levels were higher in patients with asthma. Moreover, resistin was higher in obese than nonobese patients with asthma. These findings could provide novel insights into their role in asthma and their potential use as therapeutic targets.
Predictors of residual sleepiness in patients with obstructive sleep apnea syndrome on continuous positive airway pressure
Authors: Dongol Eptehal M. , Drakatos Panagis , Muza Rexford , Badawy Ahmed Y. , Badawy Mohammed S. , Williams Adrian J.
Published: May 2023

Context

Excessive daytime sleepiness is a common symptom of obstructive sleep apnea, which improves with the application of the continuous positive airway pressure (CPAP). However, it is not unusual that some patients continue to complain of residual excessive sleepiness (RES).

Aims

We aimed in this study to evaluate the predictors of residual sleepiness in these patients.

Settings and design

This is a retrospective study done in a tertiary center, and data for the years 2010–2015 were collected.

Materials and methods

The inclusion of patients with obstructive sleep apnea syndrome and compliant on CPAP was done. We included the pretreatment apnea-hypopnea index and epworth sleepiness scale (ESS) in addition to the CPAP using parameters. Comparison between the compliant obstructive sleep apnea syndrome with RES and without RES was done.

Statistical analysis

We compared between the patients with RES and without. Regression analysis was used to detect the predictors for RES.

Results

The mean age of the compliant patients with RES was significantly younger than compliant patients without RES (54.15±10.1 vs. 59.23±10.7; P=0.001). All the patients used the CPAP adequately (≥4 h per night for ≥70% of the nights); the patients with RES used the CPAP significantly lower than the patients without RES. As for the predictors for residual sleepiness on CPAP for those patients, we found that the pretreatment ESS was a predictor as well as the CPAP-use parameters.

Conclusion

Residual excessive daytime sleepiness is common in compliant patients with obstructive sleep apnea syndrome on CPAP, and the predictors for the occurrence of residual sleepiness on CPAP are younger age, higher baseline ESS, and lower CPAP usage percent.
Clinical usefulness of Mycobacterium tuberculosis/NTM real-time polymerase chain reaction in diagnosis of tuberculosis
Authors: Rashad Alaa , Rashed Hebat-Allah G. , Zakaria Mohammed , Omar Asmaa , Hosni Amal , Nafady-Hego Hanaa
Published: May 2023

Background

Tuberculosis (TB) management and prevention of further spread is crucially based on early and prompt diagnosis. Even though conventional methods are the gold standard for detection of Mycobacterium tuberculosis (MTB), they are time consuming and do not detect nontuberculous mycobacteria in most cases. The present study evaluated Anyplex MTB/NTM real-time (RT)-PCR assay (Seegene) for TB diagnosis in pulmonary and extrapulmonary TB cases in comparison with culture on Lowenstein–Jensen as a gold standard for diagnosis of MTB.

Patients and methods

The study included 100 patients with suspected TB: pulmonary TB represented 68 patients and extrapulmonary TB represented 32 patients. All pathological samples were stained by Ziehl–Neelsen staining (ZNS), cultured on Lowenstein–Jensen media and processed for PCR by the Anyplex MTB/NTM RT-PCR.

Results

Anyplex MTB/NTM RT-PCR showed a sensitivity and specificity of 100 and 65.5%, respectively, when compared with the sensitivity and specificity of ZNS, which were 87.2 and 79.3%, respectively, in the clinically suspected pulmonary TB group. However, in the clinically suspected extrapulmonary TB group, Anyplex MTB/NTM RT-PCR had sensitivity and specificity of 100 and 79.2%, respectively, when compared with those of ZNS, which were 75 and 100%, respectively.

Conclusion

The use of Seegene Anyplex MTB/NTM assay for detection and differentiation of pulmonary and extrapulmonary TB in our area is more convenient and accurate compared with ZNS.
Usefulness of serum adenosine deaminase for diagnosing pulmonary and extrapulmonary tuberculosis
Authors: Ahmed Yousef , Farghly Sahar , Abdellatif HebatAllah
Published: May 2023

Background

Serum adenosine deaminase (ADA) measurement is a biochemical test that is believed to play a role in diagnosing tuberculosis (TB). However, few studies have been conducted in this area and there have been contradictory reports on the diagnostic value of serum ADA in TB.

Objective

The aim of the study was to evaluate the usefulness of ADA measurement in the serum for diagnosing TB.

Materials and methods

In all, 97 participants were included in this study; 28 with pulmonary tuberculosis (PTB), 20 with extrapulmonary tuberculosis (EPTB), 32 with non-TB lung disease, and 17 heathy individuals. Serum ADA activity was determined in all participants using the semiautomated biochemistry analyzer ERMA AE600N (ERMA Inc.).

Results

We found that serum ADA levels were significantly high in patients with TB (PTB and EPTB) compared with non-TB lung disease cases and healthy control. The best cutoff value in this study of serum ADA in diagnosing TB was more than 21.1 IU/l for PTB and more than 21.2 IU/l for EPTB as obtained by the receiver operating characteristic curve with high sensitivity and specificity.

Conclusion

According to the results indicating high sensitivity for serum ADA level, this test is a helpful tool for the diagnosis of TB. On the basis of high specificity for serum ADA level, this test is also a useful test to rule out TB in questionable cases.
Comparative study between microscopic observation drug susceptibility and MTB/RIF Gene Xpert in the diagnosis of pulmonary tuberculosis in a specialized Egyptian hospital
Authors: Mourad Sahar M. , Baess Ayman I. , Abdullah Reham E. , Ragab Nadia M.
Published: May 2023

Background

Diagnosis of pulmonary tuberculosis (PTB) is usually problematic regarding time and accuracy.

Aim

To compare between the microscopic observation drug susceptibility (MODS) and MTB/RIF Gene Xpert in sputum samples of PTB-suspect patients regarding sensitivity, specificity, timing to positivity, and drug susceptibility compared with the gold standard Löwenstein–Jensen (LJ) mycobacterial culture.

Patients and methods

This is a retrospective clinical study. Records of patients who were PTB suspect and who presented to El Maamoura Chest Hospital, Alexandria, Egypt, were reviewed between May 2016 and March 2018.

Results

MODS showed variable significance in prognostic performance compared with Gene Xpert regarding sensitivity (71.7 vs. 80.0%, respectively) and specificity (93.33 vs. 64.44%, respectively) compared with LJ culture. After exclusion of 29 patients who were at risk of having dead bacilli in their sputa, results showed near-similar prognostic performance between MODS and Gene Xpert regarding specificity (90.32% for both techniques) and sensitivity (72.88 vs. 79.66%, respectively). Gene Xpert showed overall superiority in time to positivity (within 3 h). MODS showed significant difference than LJ medium with timing to positivity from 7 to 22 days with mean±SD of 19.11±4.0 days.

Conclusion

For diagnosis of PTB, MODS was found to be more specific and relatively less sensitive compared with MTB/RIF Gene Xpert. With exclusion of sputum samples from patients who are at risk of having dead bacilli in their sputa, no significant difference was found between both techniques regarding sensitivity and specificity. MTB/RIF Gene Xpert has superiority in timing to positivity.
Gender-based epidemiological study of lung cancer patients
Authors: Abdelwahab Heba W. , Farrag Nesrine S. , Akl Fatma M. , Radi Ahmad A.
Published: May 2023

Background

In Egypt, lung cancer represents 5.0–7.0% of all cancers and ranks the fifth in males and both sexes, and ninth among females. The current study aims to characterize a cohort of patients with lung cancer based on their sex regarding risk factors, clinical presentation, and results of investigations.

Patients and methods

A retrospective comparative cross-sectional study was conducted that included all female lung cancer cases that were referred to the Clinical Oncology and Nuclear Medicine Department from year 2014 to year 2018. An equal number of males were randomly selected within the same year interval (as a comparative group). Data (included epidemiological data, relevant medical history, and the histopathologic type of cancer) were retrieved from the electronic database.

Results

The family history of malignancy was higher among females (8.8 vs. 0%), but the difference was not significant. There were no significant differences in performance status between male and female group. Apart from chronic obstructive pulmonary disease, the prevalence of most chronic diseases was significantly higher among females than males. Adenocarcinoma is the most common histologic subtype regardless of sex, whereas squamous cell carcinoma represented 18.5% among males and 1.9% among females, with significant difference (P=0.001). Bone was the most common site of metastasis. Overall, 14% of males had suprarenal metastasis, compared with 3.5% of females, with significant difference (P=0.047).

Conclusion

This 4-year single-center analysis concluded that both male and female present at a late stage of lung cancer. Suprarenal metastasis was more common in males than females. Squamous cell carcinoma was the most common among males. There were no sex differences regarding age of diagnosis, performance status, presenting symptoms, and radiological site of tumor.
Expression level of micro-RNA-1, IL-5, IFNγ, and TNFα in adult-onset asthmatic patients
Authors: Abo-Youssef Shaimaa M. , Allam Amira H. , Mustafa Mysa S. , Abd el Hamid Hasnaa S. , Shahat Amany K. , Moussa Hany H.
Published: May 2023

Background and objective

Asthma is an inflammatory process, where T lymphocytes cells, mainly the Th1/Th2 cells, participate in bronchial asthma’s pathogenesis and progression. Studying the inflammatory and genetic mediators’ expression levels, which control this inflammatory process like microRNAs, is essential to illustrate this disease’s pathogenesis. This work aimed to evaluate the levels of miRNA-1 and inflammatory mediators interleukin (IL)-5, interferon-γ (IFNγ), and tumor necrosis factor (TNF)-α in the peripheral blood of adult-onset asthmatic patients and their correlation to the disease severity.

Patients and methods

A case–control study was carried out on 69 participants, divided over two groups: group I was the asthmatic group, which included 49 patients with adult-onset bronchial asthma more than 18 years old, subdivided to group IA, with mild asthma (10 patients), group IB, with moderate asthma (19 patients), and group IC, with severe asthma (20 patients). Group II was the control group, which included 20 healthy individuals. IL-5, TNFα, and IFNγ were measured by enzyme-linked immunosorbent assay (ELISA) and relative quantification of MiRNA-1 expression was done by PCR.

Results

miRNA-1 decreased significantly in asthmatics and decreased more with increasing severity of the disease, with a significant positive correlation between miRNA-1 and both forced expiratory volume in first second and IFNγ, and meaningful negative relationship between miRNA-1 and both IL-5 and TNFα. The sensitivity and specificity of miRNA-1 in diagnosing asthma and detecting its severity were 100%.

Conclusion

miRNA-1 expression level is significantly decreased in adult-onset asthmatic patients. It decreases with increasing severity of the disease, with a positive correlation between miRNA-1 and plasma IFNγ but a negative relationship between miRNA-1 and both plasma IL-5 and TNFα.
Expert survey on management of prostate cancer in India
Authors: Bakshi Ganesh , Tongaonkar Hemant , Addla Sanjai , Menon Santosh , Pradhan Aditya , Kumar Abhay , Bapat Abhijit , Gore Adwaita , Joshi Amit , Raja Anand , Bradoo Anil , Ramesh Anita , Kumar Anup , Agrawal Archi , Ambekar Asawari , Joshi Ashish , Singh Ashish , Singh Bhupendra Pal , Dabkara Deepak , Khadakban Dhiraj , Gautam Gagan , Prakash Gagan , Pahwa Harvinder Singh , Goel Hemant Kumar , Kulkarni Jagdeesh , Mishra Jeeban Jyoti , Patel Kaushal , Pal Mahendra , Chibber Percy J , Tiwari Priya , Naik Radheshyam , Raghunath S K , Krishnatry Rahul , Shimpi Rajendra , Sharma Rakesh , Taran Rakesh , Trivedi Sameer , Nabar Sanjay , Surekha Sanjoy , Kumar Satish , Sawaimoon Satyakam Krishna , Raina Shailesh , Narasimha Srivatsa , Advani Suresh , Ghouse Syed Mohammed , Muddu Vamshi Krishna , Maniar Vashishth , Venkat Vivek , Murthy Vedang
Published: May 2023

To gain insights on the diverse practice patterns and treatment pathways for prostate cancer (PC) in India, the Urological Cancer Foundation convened the first Indian survey to discuss all aspects of PC, with the objective of guiding clinicians on optimizing management in PC. A modified Delphi method was used, wherein a multidisciplinary panel of oncologists treating PC across India developed a questionnaire related to screening, diagnosis and management of early, locally advanced and metastatic PC and participated in a web–based survey (WBS) (n = 62). An expert committee meeting (CM) (n = 48, subset from WBS) reviewed the ambiguous questions for better comprehension and reanalyzed the evidence to establish a revote for specific questions. The threshold for strong agreement and agreement was ≥90% and ≥75% agreement, respectively. Sixty-two questions were answered in the WBS; in the CM 31 questions were revoted and 4 questions were added. The panelists selected answers based on their best opinion and closest to their practice strategy, not considering financial constraints and access challenges. Of the 66 questions, strong agreement was reached for 17 questions and agreement was achieved for 22 questions. There were heterogeneous responses for 27 questions indicative of variegated management approaches. This is one of the first Indian survey, documenting the diverse clinical practice patterns in the management of PC in India. It aims to provide guidance in the face of technological advances, resource constraints and sparse high-level evidence..
A review on mechanisms of resistance to PARP inhibitors
Authors: Desai Chirag , Pathak Anand , Limaye Sewanti , Maniar Vashishth , Joshi Archita
Published: May 2023

Standard therapy for advanced ovarian cancer (OC) consists of radical debulking cytoreductive surgery followed by adjuvant chemotherapy. An important risk factor for OC is genetic predisposition, with BRCA1 or BRCA2 mutations accounting for the majority of hereditary OC. Mutation in BRCA ultimately causes accumulation of genetic alterations because of the failure of cells to arrest and repair DNA damage or to undergo apoptosis, resulting in tumorigenesis. Poly (ADP-ribose) polymerase (PARP) inhibitors have emerged as a promising approach for managing BRCA-associated cancers, especially high-grade OC and breast cancers. They lead to synthetic lethality in BRCA-mutated cells by stalling the replication forks in homologous recombination-deficient (HR) cells. Four PARP inhibitors (olaparib, niraparib, rucaparib, and talazoparib) are currently approved by the Food and Drug Administration for OC, breast, and pancreatic cancer indications and are being evaluated for other BRCA-associated cancers. Despite their clinical efficacy, cancer cells generally develop resistance to them through several mechanisms. Understanding these mechanisms is crucial for developing strategies to counter resistance and identify the basic mechanisms of DNA damage response. This review focuses on the mechanism of action of PARP inhibitors, understanding various causes of resistance, and building strategies to overcome PARP inhibitor resistance.
Irrational Fear of Being Away from Smartphone Among Health-Care Workers
Authors: Gokani Nikunj Satish , Deshmukh Deepanjali Dilip , Godara Praveen , Marwale Arun Vishwambhar , Bhise Manik Changoji , Jadhav Shraddha Shivaji , Murambikar Gaurav Pradeep
Published: May 2023

Introduction:

Nomophobia, i.e., No mobile phone phobia, is the irrational fear of being out of mobile phone contact. Mostly youth get very anxious on not being able to use their smartphone. Thus, identification of the extent of the problem in this population might be helpful.

Aims:

The aims of this study were to find the presence of nomophobia and its severity among the medical students, postgraduate residents, and faculty and to assess the association with certain demographic factors, mobile phone use-related factors, and nomophobia among them.

Settings and Design:

This observational, cross-sectional study was conducted in a medical college and tertiary care hospital.

Materials and Methods:

An online survey was conducted by using Google Forms and utilizing validated No Mo Nomophobia- Questionnaires. A self-reported questionnaire inclusive of demographic data, information regarding smartphone use, and factors of nomophobia was administered. A total of 446 people participated in this survey. SPSS version 20 of the institute was used. Levene's test for equality of variances, independent t-test for equality of means, and analysis of variance were used for statistical analysis. P < 0.05 was considered statistically significant.

Results:

The mean NMP-Q score was found to be 79.08. The mean age of the study participants was 22.83 years (±4.68). Majority (62%) of the participants reported moderate level of nomophobia. Factors such as female gender, MBBS students, single relationship status, and age <25 years were found to be significantly associated with higher levels of nomophobia. Participants with >50 applications in smartphone showed higher scores of nomophobia. Living arrangements, number of phones and SIM cards, and duration of cell phone use had no significant impact on nomophobia scores.

Conclusion:

A significant prevalence of nomophobia was noted among medical graduates, which highlights the need for early identification and intervention.
Psychosocial Impact of the COVID-19 Lockdown in School-Aged Children and Adolescents in Karaikal – A Longitudinal Study
Authors: Venkat Sree Latha B , Ananthakrishnan K. R.
Published: May 2023

Background:

The pandemic caused by SARS-CoV-2 has forced many nations to complete lockdown. Fear of the infection, financial loss, and insecurity of future, affect human psychology. Children and adolescents are also at risk of psychological disturbances causing behavioral problems. Increasing screen time and parental stresses add to the mental trauma.

Objectives:

The objectives of this study were to assess the prevalence of behavioral abnormalities in school-aged children and adolescents and the influence of lockdown on their behavior.

Materials and Methods:

A prospective longitudinal cohort study was conducted in the community setting of homes of healthy children aged 6–12 years (n = 123) and adolescents aged 13–18 years (n = 115) living with parents under the lockdown during March–April 2020 in the low coronavirus disease 2019 transmission district of Karaikal. Change of behavior from the 1st day of lockdown over a month was assessed using parent-completed Strength and Difficulty Questionnaire (SDQ). The total scores of initial assessments and follow-up were calculated.

Results:

At initial assessment, 4% (n = 3) of the children and 6% (n = 7) of the adolescents had high scores in four-band categorization of the parent-completed SDQ. One month in lockdown, it increased to 17.8% (n = 22) in children and 26.9% (n = 31)) in adolescents. Very high scores were recorded in 1.7% (n = 2) of children and 7.8% (n = 9) of adolescents. Emotional and hyperactivity scores were high in children (P < 0.001), while peer and conduct problems were higher in adolescents (P < 0.001). Longer screen time (P < 0.001), parental conflicts (P < 0.001), and lower socioeconomic state (P < 0.05) correlated with high scores.

Conclusion:

The psychological impact of lockdown on children and adolescents is high. Longer screen time has a serious impact on the behavior of children as well as adolescents. Parental conflicts correlated positively with adverse behavior in adolescents than children.
Quality of Sibling Relations in Children with Attention-Deficit Hyperactivity Disorder
Authors: Nachane Hrishikesh Bipin , Nayak Ajita S , Keshari Prerna , Parkar Shubhangi R , Saurabh Kumar Hement , Arora Manan
Published: May 2023

Background:

Children with attention-deficit hyperactivity disorder (ADHD) have severe impairment in their social functioning, and such literature from their sibling relations is limited. Sibling relations have several dimensions to them and a more detailed assessment into their impairment in ADHD is needed. We compared quality of sibling relations among ADHD sibling dyads and healthy controls. We also correlated the quality of sibling relations with severity of inattention and hyperactivity in ADHD.

Materials and Methods:

The present case–control study enrolled 30 cases of ADHD and 30 healthy controls from a child guidance clinic. The quality of their sibling relations was assessed by parent-rated version of the sibling relationship questionnaire (SRQ) on four domains of warmth, power struggle, conflict, and rivalry as well as their respective sub–domains. Their severity of inattention and hyperactivity was assessed using the Vanderbilt ADHD Diagnostic Parents Rating Scale (VADPRS).

Results:

ADHD sibling pairs had significantly lower warmth, prosocial behavior, affection, companionship, and competition as compared to their healthy counterparts. ADHD child was admired less by the sibling, and they were also seen to nurture each other less. The most significant difference was seen in affection (r = 0.59), followed by nurturance (r = 0.56). Intersibling conflict correlated positively with hyperactivity scores on VADPRS (ρ = 0.410, P = 0.04).

Conclusions:

Sibling relations are significantly affected in ADHD, with lower warmth and nurturance. Most significant impairment is noted in affection followed by nurturance. Intersibling conflict correlates significantly with severity of hyperactivity.
Workplace Bullying in the Service Sector
Authors: Savapandit Nimisha , Bharathi
Published: May 2023

Context:

Bullying is a problem that people, the world over, grapple with. It is manifest in different forms among different sections of people. Despite its prevalence, workplace bullying has not received much attention in scholarly literature in India. It is also not widely acknowledged as a threat to individual and organizational well-being. The purpose of this study is to add to the existing body of literature on the topic and to draw attention to the gravity of the issue.

Aims:

The primary objectives are to identify if there exist variations in its incidence on the basis of gender and years of experience, to identify the source of negative behavior, and the type of bullying that is most prevalent.

Settings and Design:

The study is a type of cross-sectional, descriptive study.

Subjects and Methods:

Data have been collected from a sample of 84 respondents using the Work Harassment Scale. All respondents are white-collar employees of the service sector in the cities of India. The data were analyzed using IBM SPSS v25.

Results:

The results find that there is no difference in the incidence of bullying on the basis of either gender or years of experience. Moreover, the source of negative behavior is generally one's superiors, and the most prevalent type is “verbal aggression.”

Conclusions:

The study concludes with suggestions of steps to be implemented at the national and organizational level, to combat the problem.
A Study on Psychological Distress, Functional Impairment, and Social Attitude Toward the COVID-19 Pandemic and Lockdown among Indian Population
Authors: Badola Meghna , Chauhan Ruby , Taneja Neha , Janardhanan Rajiv
Published: May 2023

Objective:

The objective was to evaluate the prevalence of psychological distress, functional impairment, and social attitude toward the COVID-19 pandemic and induced lockdown among the Indian population.

Methodology:

A cross-sectional study was conducted among 155 people residing in India. Data were collected on sociodemographic variables, psychological distress, functional impairment, and social attitude toward COVID-19 and the induced lockdown via an online survey. Kessler's K10 scale was used to measure psychological distress and Work and Social Adjustment Scale (WSAS) was used to evaluate functional impairment due to the COVID-19 pandemic. Descriptive statistic and Chi-square test were applied, where P < 0.05 was considered statistically significant. Pearson's analysis was used to measure the correlation between psychological distress and functional impairment.

Results:

Overall, the mean age of the study participants was 29.24 (standard deviation = 7.869) years. Majority of the study participants were female (63.9%). On applying K10 scale, it was found that 20% of the participants suffered from mild psychological distress and 16.1% were moderate-to-severely distressed. On applying WSAS scale, it was found that 23.9% of the study participants suffered from significant functional impairment and 7.9% from severe functional impairment. On assessing the social attitude, 63.9% of the participants purchased groceries from local market and 56.8% said that they would visit mall after the lockdown gets over. Eating out in a restaurant (P = 0.028) and visiting shopping mall (P = 0.032) after the lockdown gets over were significantly associated with psychological distress.

Conclusion:

Our findings identified the level of psychological distress, functional impairment, and social attitude toward the COVID-19 pandemic and the induced lockdown. Such evidences can be used to formulate interventions to improve the mental health and well-being of people during such emergencies.
Experiences of Quarantine for Individuals during the COVID-19 Outbreak in Kashmir
Authors: Maqbool Zahid
Published: May 2023

Context:

The coronavirus disease 2019 (COVID-19) outbreak originally occurred from Wuhan, China, in December 2019 and gradually spread to other countries in different parts of the world. The COVID-19 outbreak has led many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in administrative quarantine facilities. Thus, quarantine at different levels, from individual to community, was seen as an effective measure of preventing the spread of this disease.

Aims:

The aim of the present study is to explore the experiences of quarantine for individuals returning from Bangladesh during the COVID-19 outbreak in Kashmir.

Settings and Design:

This study follows qualitative narrative design.

Subjects and Methods:

This study used an in-depth, semi-structured interview guide. Purposive sampling technique was used to select the participants who varied in terms of gender and age.

Results:

Despite individual differences, the experiences narrated by participants followed stages beginning before, during, and after ending the quarantine. The government authorities adopted a policy of mandatory quarantine to all the incoming passengers with the aim of preventing the spread of this pandemic. However, participants reported facing several issues such as shock and fear, feeling of isolation and loneliness, frustration and boredom, and loss of routine activities during this period.

Conclusions:

Quarantine as a method of preventing transmission of severe disease outbreak should be carefully used after effectively weighing its potential benefits and risks. The results of the study can be used to devise a proper policy framework and practice for effectively managing future quarantine and isolation-related health emergencies.
Digital Technology Use among Adolescents in a Psychiatric Inpatient Setting
Authors: Hossien SK Altaf , Sharma Eesha , Girimaji Satish Chandra
Published: May 2023

Technology enhances social communication and connectedness, people. However, it may predispose youth with socioemotional and psychological vulnerabilities, such as mental health disorders, to further behavioral and emotional dysregulation and adverse experiences such as cyber-bullying. We assessed digital technology use among adolescents requiring psychiatric inpatient care, i.e., with moderate-severe mental health morbidity. We found that over 95% of adolescents had regular digital technology use, via mobiles or tablets. The prevalence of problematic use was ~30% while technology addiction could be detected in close to 6%. A particularly concerning issue was the near-constant use of technology throughout the day, in almost 40% of adolescents, especially those with externalizing disorders, severely compromising time remaining for other developmentally appropriate engagements. Our findings suggest the need to incorporate assessment of digital technology use in the clinical evaluation of adolescents with mental illnesses. This would have critical implications for developmentally informed, life-skills-based interventions that are contemporaneous with the rapidly evolving digital-human interface in this population.
Problematic Internet Use and its Association with Psychological Stress among Adolescents
Authors: Anand Nitin , Sharma Manoj Kumar , Marimuthu P
Published: May 2023

Background:

Problematic use of the Internet and psychological stress are interrelated in many ways. The psychological stress originating from Internet usage can create an unfavorable impact on adolescents. These impacts vary from academic progress to competence, career goals, and nonacademic intellectual involvement, hindering skill development. Thus, there is a need to evaluate problematic Internet usage among adolescents.

Aim and Objectives:

This study was set up to examine Internet usage behaviors, problematic Internet use (PIU), and its association with psychological stress among adolescents from India.

Materials and Methods:

Six hundred and eighty-two adolescents aged between 15 and 18 years, studying at high school and senior secondary level from institutes primarily situated in South India, participated in the study. The patterns of Internet usage and sociodemographic data were collected through online and sociodemographic forms. Along with this, the Internet Addiction Test (IAT) was employed to assess PIU, and symptoms of psychological distress were evaluated with the Kessler Psychological Distress Scale (K10).

Results:

Among the total sample of 682 (N), 36.6% (N = 248) of adolescents met criterion on IAT for mild Internet addiction/PIU, 31.96% (N = 218) for moderate Internet addiction/PIU, and 2.93% (N = 20) for severe Internet addiction/PIU. PIU was higher among adolescents who accessed the Internet several times a day and had experienced psychological stress. In addition, stepwise regression analysis indicated that adolescents experiencing psychological stress were at higher risk for engaging in PIU, and stress also predicted engagement in PIU.

Conclusions:

PIU was present among a substantial proportion of adolescents, which might hinder their academic performance and progress over some time and can impact their psychological health adversely. These adolescents are likely to benefit from the early identification of PIU, which can facilitate the timely implementation of psychotherapeutic intervention strategies for PIU in school settings.
Factors Determining Psychological Stress among Indian Adolescents and Young Adults during the COVID-19 Outbreak
Authors: Agarwal Neha , Harikar Mandara Muralidhar , Shukla Rishi , Bajpai Anurag
Published: May 2023

Background:

Strict isolation measures imposed during the coronavirus disease (COVID-19) pandemic have confined families in their homes, interrupted functioning of schools and colleges, and disrupted play and exploration time.

Aim:

The aim was to analyze psychological stress and its determinants among Indian adolescents and young adults during the COVID-19 pandemic.

Methodology:

A cross-sectional, observational study design was adopted. A semi-structured survey including demographic details, COVID-19 awareness, Perceived Stress Scale (PSS-10), and coping methods was distributed among 12–24 year olds, and analyzed to study the determinants of stress.

Results:

Out of a total of 235 (112 males; 19.4 ± 4.0 years) participants, nearly half of the participants (53%) reported moderate stress; low stress was perceived by 42.3% and severe stress was observed in 4.7%. The mean PSS score was 13.4 ± 8.9. Higher PSS score was associated with age (r = 0.194, P = 0.003), female gender (mean rank = 132.0, P = 0.001), higher education (mean rank = 154.5, P = 0.006), salaried occupation (mean rank = 143.79, P = 0.047), dissatisfaction with the available information (mean rank = 155.64, P = 0.009), and accessing information multiple times a day (mean rank = 133.51, P = 0.041). On multivariate linear regression analysis, age, gender, dissatisfaction with the available information, and higher frequency of accessing information were identified as significant correlates of mean PSS-10 score.

Conclusion:

Stress was highly prevalent among the Indian adolescents and young adults during the pandemic. Older age, female gender, higher education, salaried job, dissatisfaction toward the available information, and a tendency to view updates frequently were associated with higher stress levels.
Impact of the Lockdown Following COVID-19 on Online Interest for Digital Gaming in India
Authors: Sharma Pawan , Singh Swarndeep , Balhara Yatan Pal Singh
Published: May 2023

There has been increased interest in media and the World Health Organization advisory regarding digital gaming. We did a Google Trend study using relative search volumes (RSVs) for the keywords identifying with different themes related to digital gaming. It was seen that there was a significant increase in RSVs in the Indian population for the keywords identifying with online gaming, reward-seeking, and genres or types of games. Although online gaming is an easy way to engage during the lockdown, the risks due to excessive engagement cannot be ignored. We recommend balanced and effective approaches for gaming during lockdown for physical and psychological well-being.
Role of Nongovernmental Organizations in Community Mental Health
Authors: Rangaswamy Thara , Rao D. Kotteswara , John Sujit
Published: May 2023

This article focuses on the work done by nongovernmental Organizations (NGOs) in mental health (MH) in India and will illustrate in broad strokes the growth of NGOs in the MH sector. It describes the evolution of MH services over the years with specific emphasis on community MH activities undertaken by NGOs. The role of the MH NGO in bridging the MH gap and the activities that have been undertaken ranging from primary prevention work to tertiary care is discussed. The inherent strengths that the NGOs have in working with communities and their ability to provide holistic care and services beyond the medical model by involving a wide array of workers ranging from MH professionals to peer support providers is examined. The need for private–public partnership in MH is emphasized as the way forward along with leveraging digital technologies that has now come into sharp focus following the COVID pandemic.
Community Management of Substance Use Disorders
Authors: Sharma Kshitiz , Mahintamani Tathagata , Subodh BN , Basu Debasish
Published: May 2023

Substance use disorder (SUD) is a common entity in the Indian population, with a huge treatment gap of around 90%. Poor availability, accessibility and acceptability due to various reasons contribute to the treatment gap. The management of SUD at the community level can reduce this gap. Various private, government, and nongovernmental organizations (NGOs) are the leading agencies to provide pharmacological and nonpharmacological treatment at the community level in India. Historically, addiction treatment “camps” were efficient, cost-effective, and resource-saving community treatment approaches. Conventionally, there has been an attempt to integrate SUD treatment in primary healthcare, but this requires training and resource development at the community level. Outreach clinics, organized by tertiary care hospitals, help in training and research, besides catering to the community need for treatment. NGOs also help in the provision of treatment, awareness generation and capacity building at the community level. Currently, integration of screening and brief intervention with primary care is being tried in various community setups. This approach would be more effective with an efficient referral system. Telemedicine emerged as a new tool during the Coronavirus disease-19 pandemic. Telemedicine has been efficiently incorporated in the hub and spoke model and has been found to enhance the community treatment of difficult to reach patients with SUD. Various modifications in telemedicine help in more efficient diagnosis, decision-making, and treatment. Proper integration of multiple approaches can help in effective service delivery in a resource-limited setup in the community.
Family Caregivers of Persons Living with Mental Health Conditions
Authors: Bakhshy Amrit
Published: May 2023

A vast majority of persons diagnosed with mental disorders live with their families in most of the low- and middle-income countries. There is a growing evidence of the adverse impact of caregiving on the caregivers. There is a need to recognize the significant contribution of caregivers. Specific programs to improve skills of self-care for emotional health, skills of caregiving, social welfare, and legislative support to caregivers will make them more effective and further decrease the demand on mental health services. This is an urgent need. India has the opportunity to show the way through innovative training, legislative, and other measures.