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Caregiver Burden and Resilience in Family Members of Alcohol Dependent Patients: Observations from Eastern India
Get PDFBackground: Caregiver burden for alcohol dependent patients refers to the physical, emotional, financial, and social challenges faced by individuals who provide care and support to someone struggling with alcohol dependence. Caregivers often experience high levels of stress, anxiety, and emotional distress when dealing with a loved one\u27s alcohol dependence. The present study tried to analyse the caregiver burden and resilience among family members of alcohol dependent individuals in eastern India.
Methods: A cross-sectional observational study patients attending general outpatient clinics who had positive alcohol consumption history and were being accompanied by their caregivers to the facility. Patient and caregiver’s demographics were noted followed by caregiver’s burden and resilience indices using Burden Scale for Family Caregiving (BSFC) and Brief Resilience Scale (BRS). Responses were analysed statistically.
Results: 35.9% patients severely alcohol dependent. Composite caregiver burden score showed 50.6% caregivers were moderately burdened, followed by 37.6% caregivers who were found to be severely burdened. Most caregivers showed low resilience. Severity of alcohol dependence was positively correlated with patient’s age, while caregiver’s burden was found to have significant positive correlation with both patient and caregiver’s age, and severity of alcohol dependence. Resilience was negatively correlated with patient as well as caregiver’s age and severity of alcohol dependence (p=0.000). Female caregivers reported lower resilience as compared to male caregivers (p=0.003).
Conclusion: Caregiving is a challenging responsibility. It is important for caregivers to recognize the impact of alcohol dependence on their lives and to seek support, both for themselves and for the person with addiction
A Cross-Sectional Comparative Study Of select Cognitive Functions in Adolescent Medical Students Engaged in Physical Activities and Video Gaming
Get PDFBackground: This study was conducted to compare the performance of cognitive function tests among adolescent students involved in physical activities, video-gaming, and board-gaming groups.
Methods: A cohort of 300 participants (150 males and 150 females) were included in the study. The participants were divided into 3 groups (50 boys and 50 girls each) who were engaged regularly in physical activity, video gaming activity and board gaming activity respectively. The participants of all the groups were tested on selected neurocognitive tests from Wechsler Memory Scale – III (WMS – III) and NIMHANS Neuropsychological Battery. After acquiring baseline data, they were instructed to continue their respective gaming activities for a minimum of 2 hours each day. After 30 days of respective gaming activity, the battery of cognitive tests was administered again, and the pre and post results compared.
Results: There was a statistically significant difference in the subset scores of Tests for Visual Presentation (Faces I and II) in the boys and girls of the Physical Activity group and gaming group independently. The AVLT scores showed statistically significant difference between girls and boys who were engaged in 30 days of board or video gaming activity.
Conclusions: Our study shows that in the short term, there are differences in the cognitive performances of participants of the 3 groups of activities. Along-term follow-up study will help to differentiate the effect of these 3 activities upon cognitive function. Cognitive functions of young adults of both gender is influenced by physical and gaming activity
The Pros and Cons of Systematic Review and Meta-Analysis: Methodological Insights and Future Directions
Get PDFSystematic reviews (SR) and meta-analyses (MA) are the highest level of evidence in the hierarchy of scientific evidence which aggregate data from various studies, offering a comprehensive overview of a particular topic. This approach reduces the influence of isolated studies that may have small sample sizes or unique biases, leading to more robust conclusions. By combining data from multiple studies, the overall sample size is increased enhancing the statistical power and precision of the results. The value of SR and MA is often compromised by the poor quality of the primary studies they include, which can lead to misleading conclusions. Many SRs were found flawed, redundant, or biased, which diminishes their reliability It is crucial to consider both the strengths and limitations of Systematic reviews to draw a valid conclusion. They must be critically appraised and updated regularly to maintain their validity as an invaluable tool in evidence-based medicine. Advanced analytical tools and supervised use of AI may add to the accuracy of SR and MA. By doing so, they can make more informed decisions that truly benefit patients and advance scientific understanding
Exploring the Elective Experience: A Review of the Adult Psychiatry Elective at a Medical College
Get PDFThis review delves into the motivations, experiences, and perceived advantages and disadvantages of undertaking the \u27Adult Psychiatry\u27 as an elective at JSS Medical College. Experiences from four students, two from the 2019 batch and two from the 2020 batch, provide a comprehensive overview of their elective
Atypical Immune Response: Acquired Hemolytic Anemia in a Non-Hodgkin Lymphoma Patient with Unusual Findings
Get PDFAcquired hemolytic anemia, caused by external factors like autoimmune disorders or infections, includes rare cases of Cold Agglutinin Syndrome (CAS), a cold-antibody-mediated condition affecting 1 in 1 million annually. This report highlights a unique case of CAS in a patient with Non-Hodgkin lymphoma and polyclonal gammopathy, contrasting with the typical presentation of warm-reactive autoantibodies and monoclonal antibodies. The patient presented with weakness, breathlessness, and splenomegaly, with laboratory findings showing a hemoglobin level of 5.8 g/dL and elevated ferritin. Imaging revealed mesenteric lymphadenopathy and thickening of the cecum, suggesting possible lymphomatous involvement. Non-Hodgkin lymphoma was confirmed via lymph node biopsy. This case underscores the importance of recognizing atypical presentations of hemolytic anemia, such as CAS, in lymphoma patients, where warm-reactive autoantibodies typically dominate in similar cases
Osteochondroma at Unusual Location Causing Deformity (Metacarpal): A Rare Case Report
Get PDFINTRODUCTION: Osteochondroma is benign tumors of bone which usually occurs in long bones. Common locations proximal tibia, distal femur and proximal humerus. Metacarpals are rarely affected.
Case Report: Patient, 10 years old/boy came to JSS hospital with complaint of swelling and deformity over left hand for 2 years. After relevant clinical examination and radiological investigation, patient was diagnosed with synostoses of 5th metacarpal with 4th metacarpal. Patient was taken up deformity correction and intra-op patient was diagnosed as exostoses of 5th metacarpal. Post-op radiograph was taken. After 1-month ex-fix was removed. After 4 months follow up, deformity was corrected and patient achieved full ROM.
CONCLUSION: Although unusual, osteochondromas can present in the hand and need to be evaluated suspiciously. These are mostly asymptomatic but can present with pain, deformity and other pressure symptoms. Therefore, it is important to thoroughly evaluate the patients with bony swelling to correctly diagnose osteochondromas and manage accordingly and to monitor for sign of recurrence and malignancy
Understanding Patient Outcomes in Neurological Disorders: Insights from NDDI-E and EQ-5D-5L Assessments
Get PDFBackground: Patient-Reported Outcome Measures (PROMs) play a critical role in improving patient engagement in therapy, symptom assessment, functional status, psychological well-being, and health-related quality of life (HRQoL) in neurological patient care. In addition, PROMs provide valuable insights for evaluating the effectiveness of interventions, comparing patient and organizational outcomes, and generating new information.
Objective: This study aimed to assess patient-reported outcomes using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and the EQ -5D-5L in patients with neurological disorders.
Methods: A six-month hospital-based observational cohort study was conducted in a South Indian tertiary care hospital, enrolling patients diagnosed with various neurological diseases. Standardized questionnaires, NDDI-E (for depression and suicidality screening in epilepsy), and EQ-5D-5L (for overall HRQoL assessment) were used to capture patient-reported outcome measures. Data analysis was performed categorically and is presented as n (%).
Results: NDDI-E and EQ-5D-5L questionnaires were administered to 310 patients. Among 82 people with epilepsy assessed using the NDDI-E, 19.51% were identified as having depression, and 10.98% had positive suicidal screening. The remaining 228 patients with other neurological disorders completed the EQ-5D-5L, with 70% reporting no problems in walking, 68% in self-care, and approximately 12.5% experiencing extreme anxiety. Various EQ-5D-5L health states were detected, with the most frequent being 22222, indicating slight limitations in all domains. A perfect health state, denoted by a score of 11111, was reported by 20 participants.
Conclusion: The results support the feasibility of using the EQ -5D-5L in neurological practice to optimize patient-centered care. The NDDI-E enables rapid detection and improved treatment of depression and suicidality in patients with epilepsy
Internet addiction: A Growing Threat: A cross-sectional among the Undergraduate medical students of Tertiary care Hospital, Mysuru
Get PDFBackground: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.
Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1st to November 30th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the Internet Addiction Test. Data were entered into MS Excel and analyzed using SPSS Version 26.0.
Results: The prevalence of severe internet addiction was found to be 0.4 %, moderate addiction was found to be 27.8%, mild addiction was found to be 71.8% and there were no normal users. It was also found that 27.8% of males and 43.9 % of females have mild internet addiction, 14.9% and 12.9% have moderate internet addiction and 0.4% of females have severe internet addiction and there was no association between gender and internet addiction.
Conclusion: Increased awareness of this issue among college professors and students is necessary, as is the development of a comprehensive program for students, to identify individuals who are at risk of developing an internet addiction before it becomes pathological
Effect of repeated heating on Chemical Properties of selected edible plant oil and its Health Hazards
Get PDFIncrease in the cost price of edible oil, has forced to reuse the cooking oil especially in frying. Repeated cooking of oil brings about lot of structural changes ideally not suitable for consumption. The present study aims at comparing the structure and chemical changes like acid value, peroxide value, saponification, iodine value of three different commonly used edible oil viz sunflower oil, coconut oil & rice bran oil after successive heating & cooling. Oils were heated four times for 45 minutes, followed by repeated cooling for 2 hours. The results indicates that the acid values of all three oils (0.32- 1.36mg KOH/g)were in line with recommended standard values. The saponification values were gradually increased after every heating in rice bran oil, after the third heating the values crossed the standard limit(252- 278.10mgKOH/g in Coconut oil, 184.23-198.00mgKOH/g in Sunflower oil and 190.81-199.99mgKOH/g in Rice Bran oil.). In coconut and sunflower oil the peroxide values exceeded the standard limit after second heating whereas, in rice bran oil the values exceeded after the first heating implying rancidity releasing free radicals upon heating, peroxide value of Coconut oil (1.00-52.00meq/kg), Sunflower oil (1.00-47.00meq/kg) and Rice Bran oil (10.00-160.00meq/kg), increasing peroxide value over repeated heating indicates higher degree of oxidative rancidity. First heating of all oil showed low acid value indicating stability against peroxidation & rancidity, value increased after repeated heating. Based on the experimental evidence it may be concluded that three commonly used cooking oil, coconut oil, sunflower oil and rice bran oil undergo structural and chemical changes upon repeated heating. However coconut oil and sunflower oil showed structural stability upto second heating, low acid value, saponification ,iodine value and peroxide value were in accordance with reference, where as rice bran oil after first heating showed attributes of oil deterioration with high acid value, saponification, iodine number. Rice bran oil might be good source of other supplemental additives but its repeated heated oil re usage has to be avoided to minimize health risk.
Key words: Edible oil, heating, chemical properties, acid value, peroxide value, iodine valu
Desvenlafaxine induced acute angle-closure glaucoma - Case report
Get PDFThe World Health Organization (WHO) estimates that Depressive disorder affects more than 264 million people worldwide. The global prevalence of depression among those who are aged 18 years and older was approximately 4.4%. According to a 2017 study by India\u27s National Institute of Mental Health and Neuroscience s (NIMHANS), 7.5% of the population in the nation suffers from depression affecting one in 20 Indians[1].
SSRIs ( Selective Serotonin Re uptake Inhibitors) and SNRIs ( serotonin-nor epinephrine re uptake inhibitors) are increasingly the first-line choices of anti-depressant because of their tolerable side-effect profile and low rate of lethality if taken in an overdose. Desvenlafaxine is a specific inhibitor of serotonin-nor epinephrine re uptake (SNRI) which desensitizes the feedback systems that regulate the rate-limiting enzyme in 5-HT(5-hydroxytryptamine) production resulting in an increase in the levels of serotonin (5-HT) in the post-synaptic region. Human eyes have been found to contain serotonin (5-HT) receptors. Also, it has been noted that compared to non-mammalian species, mammalian ciliary bodies and corneas have a larger concentration of serotonin (5-HT) receptors[2].
Glaucoma is defined as a heterogeneous group of diseases that have in common a characteristic optic neuropathy and visual defects, for which elevated IOP is the primary risk factor. It affects 76 million people globally[3]. Due to the uncertainty surrounding the incidence of glaucoma caused by local or systemic therapy, these numbers may not include drug- induced glaucoma cases. Acute angle-closure glaucoma affects 10 out of every 100,000 people. The narrow angle of the anterior chamber, shallow depth of the anterior chamber, hyperopia, tiny eyes, positive family history of angle closure, ageing, female sex, usage of drugs that produce papillary dilatation, and stressful events are risk factors for angle-closure glaucoma. Several medication classes, including adrenergic agonists, cholinergic, anticholinergics, sulpha-based medicines, selective serotonin re uptake inhibitors, tricyclic and tetracyclic antidepressants, anticoagulants, and H1 and H2 receptor antagonists, can induce or worsen angle-closure glaucoma. Even though anti-cholinergic side effects or elevated serotonin levels, which produce partial papillary dilatation, have been suggested, the pathophysiological mechanism of SNRI-induced acute angle-closure glaucoma is still unknown[4]