O papel da pesquisa na prevenção de transtornos mentais

National Institute of Mental HealthUniversidade Federal de São Paulo (UNIFESP) Department of PsychiatryUNIFESP, Department of PsychiatrySciEL

Marriage and other psychological stressors in the causation of psychiatric disorder

The aim of this study was to compare the specific psychiatric diagnosis, frequency, and types of stressors, and the level of awareness about marriage law between married (cases; n=80) and unmarried girls (control; n=80) with one or more psychiatric disorders below the age of 18 years. The psychiatric diseases were diagnosed according to Axis One of ICD-10 clinical diagnoses of multi-axial classification of childhood and adolescent psychiatric disorder. Psychosocial stressors were considered on the basis of Axis Five of this classification. Of the cases, major depressive disorder was the highest (n=47) and next was a dissociative (conversion) disorder (n=24). Among the controls, generalized anxiety disorder (n=31) was the most prevalent followed by obsessive-compulsive disorder (n=17). The difference was highly significant (p>0.001). The cases reported a significant excess of psychosocial stressors than that of the controls to the onset of the psychiatric disorder. All the cases had associated stressors. In contrast, 77 out of 80 control patients had stressors. Marriage itself played as a stressor in the 78 cases. Beside this, other highly frequent stressors were marital discord followed by drop out from study and trouble with in-laws. Among the controls, the highest reported stressor was increased academic workload and next two commonest stressors were poor academic performance and discord with peers. Interestingly, 52.5% of the cases were having knowledge about the law on the age of marriage and that was 32.5% among the controls. It was significant that most of the girls breached their continuity of education after marriage (p>0.001). In conclusion, psychosocial stressors including marriage have a causal relationship with depressive and conversion disorder.

Behavioral and psychosocial predictors of depression in Bangladeshi medical students: a cross-sectional study [version 1; peer review: 2 approved]

Background: Depression, stress, and anxiety were found in a large number of medical undergraduate students, indicating a neglected aspect of their psychology that required immediate attention. The goal of this study was to find out the prevalence of depression among medical students, as well as potential psychosocial and behavioral predictors for depression.  Methods:   This cross-sectional study was conducted from July to November 2021 among 840 randomly selected medical students from four medical colleges using stratified random sampling. Data were collected using a semi-structured, self-administered questionnaire and were analyzed through the SPSS v.23 software. Multiple regression was performed to assess the effect of several behavioral and psychosocial factors on depression.   Results: Among the 840 study participants, 55.7% (n= 468) were female and 44.3% (n= 372) were male. According to the data, the prevalence of depression, anxiety, perceived stress among medical students was found to be 28.8%, 65% and 85% respectively. A strong link was found between depression and anxiety, stress, poor sleep quality, poor academic performance, and a negative social and romantic relationship status.   Conclusions: A significant number of medical students are depressed. In order to prevent and treat depression, medical students should be screened for depression and its associated factors

Adaptation, linguistic and clinimetric validation of the Bangla version of Zarit Burden Interview

The aim of this study was to develop a culturally adapted and validated Bangla version of Zarit Burden Interview  (ZBI-B) questionnaire for use in Bangla speaking caregiver of patient with dementia. This study was conducted on 100 caregivers related to consecutively attending outpatients with a previously established primary diagnosis of dementia, according to DSM-IV criteria. Validity and reliability were evaluated by comparing with the caregiver burden inventory (CBI). An exploratory factor analysis with the principle component with varimax rotation was used to detect the factorial structure in observed measurements. To attain the best-fitting structure and the correct number of factors, the following criteria were used: Eigen values >1.0, factor loadings >0.30. The Cronbachs alpha value was 0.847 for test and 0.839 retest. The intra-class correlation for the test-retest reliability was 0.89. The ZBI score was highly correlated with the CBI score (Pearsons correlation coefficient, r=0.909, P=.001). From the exploratory factor analysis six factors comprising 20 items were extracted with Eigen values higher than 1.00 accounting for 69% of the total item variance. In conclusion, ZBI-B is valid, reliable and useful for use in clinical contexts and in future studies that could lead to a better understanding of caregiver burden in dementia

Pathways to care of patients with mental health problems in Bangladesh

Background: Health systems in Bangladesh are not fully organized to provide optimal care services to patients with mental health problems. There is both a lack of resources and a disproportional distribution of the available resources. To design an equitable health system and plan interventions to improve access to care, a better understanding of mental health care-seeking behavior and care pathways are crucial. Methods: A facility-based cross-sectional study was conducted using a mixed-method design at the National Institute of Mental Health (NIMH), in Bangladesh. A total of 40 patients (or their attendants) visiting the outpatient department of NIMH were selected by purposive sampling. Results: As their first contact point for care services, 27.5% of the patients consulted a psychiatric care provider, 30% went to non-medical provider, and the majority, 42.5%, went to non-psychiatric medical care providers. Only 32.5% of the patients had been advised to go to NIMH by a private physician, hospital personnel or psychiatrist. Among all individual categories of providers, private psychiatrists were the most frequent caregivers (n = 12), followed by traditional healers (n = 9). A total of 70% of the patients had chosen a provider within 20 km. In three out of four of the cases, the family had decided on the first provider. From the start of the symptoms the median delay in the first contact with any provider was 6 months, and in reaching any psychiatric care provider was 1 year. The most common reasons for a delay in seeking care were a lack of knowledge about mental health problems, a lack of information about the place for appropriate care, and not considering the problem as serious enough to seek care. Each of those reasons were mentioned by one in every four respondents. Conclusions: The majority of the patients with mental health problems in Bangladesh access various categories of providers before reaching a psychiatric care provider, and use a diverse range of pathways and loops, which results in a delay or missing appropriate care. We hope that our findings are useful for planning interventions to improve access to mental health care in general, in Bangladesh, and improving referral policies and structures in particular

Effect of Mahkota Dewa fruit extract on kidney functions in mice

Mahkota dewa fruit is known for its antidiabetic effect and is commonly used in Malaysia, Indonesia, Philippine, Thailand and Oceania. However, there is still insufficient information available to validate the safe dose of the fruit extract for human use. Hence, the aim of this research was to determine the safe dose for renal function in mice. Materials and Methods: [MM2] The subcritical liquid carbon dioxide extract of Mahkota dewa fruit was prepared and administered via oral gavage to two groups (normal and 3000 mg/kg bw based on up and down procedure) for acute toxicity according to the OECD-425, 2008 and five groups viz. normal control, 250, 500, 1000 and 2000 mg/kg bw for sub-acute toxicity according to the OECD-407, 2008. The renal function parameters such as urea, creatinine and morphological observation of kidney tissue were analysed. Results: [MM3] The extract exhibited no mortality, morbidity, and no change in general behaviour up to a dosage of 3000 mg/kg body weight (LD 50 >3000 mg/kg). [MM4] The result of urea markedly rose to 76.71 mg/dL and 87.38 mg/dL compared to the control group (48.46 mg/dL) at doses of 1000 and 2000 mg/kg bw respectively. Similarly, creatinine value was also increased 0.87 mg/dL and 0.94 mg/dL compared to the control group (0.61 mg/dL) at doses of 1000 and 2000 mg/kg bw respectively. Moreover, the abnormal morphological finding was also found such as dilated tubules, focal degeneration, apoptosis, renal lesions/tissue haemorrhages of kidney tissue in the same doses (1000 and 2000 mg/kg bw. On the other hand, normal biochemical and histological findings were found at doses of 250 and 500 mg/kg bw in comparison to the normal control group. Conclusion: The findings revealed that Mahkota dewa fruit extract up to 500 mg/kg bw is a safe dose that would offer a greater therapeutic benefit without causing any nephrotoxicity effects. However, further clinical trials are still warranted to determine a safe dose before its commercialization

Assessment of liver acute toxicity in mice of the God’s crown extract

God’s crown (GC) is a traditional herbal plant that grows all year long. It is widely available throughout the Southeast Asian region, with the highest concentrations in Malaysia, Indonesia, and Oceania. In traditional and complementary medicine various parts of GC have been used effectively in preventing and controlling symptoms of different diseases such as kidney, diabetes, stroke, haemorrhoids, cancer, migraine, impotence, allergies, heart disease, acne, and other skin problems. The use of herbal products in a safe manner is extremely important for human beings. But there are still insufficient data on GC acute toxicity and safety. As a result, toxicological testing of GC extracts in experimental animals is a requirement for clinical trials and future therapeutic applications. The aim of this research was to analyze the acute toxicity in the mice model of GC extract. The subcritical extract of GC was designed and administrated in mice for the evaluation of acute toxicity and hepatoprotective activity according to the OECD guidelines 425. The liver function parameters such as alkaline phosphatase (ALP), aspartate aminotransferase (AST), total protein (TP), alanine aminotransferase (ALT), and morphological observation of liver tissue were analyzed consequently. The subcritical extract did not show any mortality and no changes in general behavior up to a dose of 3000 mg/kg body weight (3000mg/kg>LD 50 ). The histopathological profile of the extract-treated liver tissue demonstrated similar morphology as that of normal controls at doses 500 mg/kg body weight. On the other hand, acute toxicity is reflected by the various investigated parameters apart from mild liver histopathological inflammatory changes which reflect mild liver injury induced by the 1000mg/kg body weight. As a result, when developing GC-based phytomedicine, it is important to consider the selection of an appropriate dose that will provide better activity while minimizing adverse side effects

In vitro α-glucosidase inhibitory activity of Mahkota Dewa fruit flesh using different extraction methods

Purpose: Before using any plant for medicinal purposes, the proper extraction method must be considered for the bioactive compounds, which can be either polar or non-polar or both, and its advantages and disadvantages, depending on the selection process. The aim of this research was to compare the α-glucosidase inhibitory activity of Mahkota dewa fruit flesh using conventional and non-conventional extraction techniques. Method: The extraction was performed by heat reflex (HR), supercritical fluid extraction (SFE), and subcritical carbon dioxide (Sub-CO2) extraction using different temperatures, pressure, solvent ratio, flow rate. The optimized extracts were analyzed for a-glucosidase inhibitory activity with Saccharomyces cerevisiae enzyme. Result: The yields and α-glucosidase inhibitory activity of the Mahkota dewa extracts were analyzed. The yield was obtained in the order of HR>SubCO2>SFE on the other hand the IC50 value of α- glucosidase inhibitory activity was estimated in the order of SubCO2> HR >SFE due to its mild operating temperature and relatively low-pressure condition. Because carbon dioxide is a non- polar solvent that prefers mostly non-polar compounds, adding a co- solvent increases its polarity and improves the ability to extract more polar compounds. Furthermore, after depressurization, carbon dioxide can be easily separated from the end product. As a result, SubCO2 is the most practical extraction method for achieving higher quality of extract. Conclusion: The composition and bioactivities of extracts of natural products were typically influenced by the extracting method, solvent, and temperature

Interactive IIoT-Based 5DOF Robotic Arm for Upper Limb Telerehabilitation

Significant advancements in contemporary telemedicine applications enforce the demand for effective and intuitive telerehabilitation tools. Telerehabilitation can minimize the distance, travel burden, and costs between rehabilitative patients and therapists. This research introduces an interactive novel telerehabilitation system that integrates the Industrial Internet of Things (IIoT) platform with a robotic manipulator named xARm-5, aiming to deliver rehabilitation therapies to individuals with upper limb dysfunctions. With the proposed system, a therapist can provide upper limb rehab exercises remotely using an augmented reality (AR) user interface (UI) developed using Vuforia Studio, which transmits bidirectional data through the IIoT platform. The proposed system has a stable communication architecture and low teleoperation latency. Experimental results revealed that with the developed telerehabilitation framework, the xArm-5 could be teleoperated from the developed AR platform and/or use a joystick to provide standard upper limb rehab exercises. Besides, with the designed AR-based UI, a therapist can monitor rehab/robot trajectories along with the AR digital twin of the robot, ensuring that the robot is providing passive therapy for shoulder and elbow movements

qDTY1.1, a major QTL for rice grain yield under reproductive-stage drought stress with a consistent effect in multiple elite genetic backgrounds

<p>Abstract</p> <p>Background</p> <p>Drought is one of the most important abiotic stresses causing drastic reductions in yield in rainfed rice environments. The suitability of grain yield (GY) under drought as a selection criterion has been reported in the past few years. Most of the quantitative trait loci (QTLs) for GY under drought in rice reported so far has been in the background of low-yielding susceptible varieties. Such QTLs have not shown a similar effect in multiple high- yielding drought-susceptible varieties, thus limiting their use in marker-assisted selection. Genetic control of GY under reproductive-stage drought stress (RS) in elite genetic backgrounds was studied in three F_3:4mapping populations derived from crosses of N22, a drought-tolerant <it>aus </it>cultivar, with Swarna, IR64, and MTU1010, three high-yielding popular mega-varieties, with the aim to identify QTLs for GY under RS that show a consistent effect in multiple elite genetic backgrounds. Three populations were phenotyped under RS in the dry seasons (DS) of 2009 and 2010 at IRRI. For genotyping, whole-genome scans for N22/MTU1010 and bulked segregant analysis for N22/Swarna and N22/IR64 were employed using SSR markers.</p> <p>Results</p> <p>A major QTL for GY under RS, <it>qDTY_1.1</it>, was identified on rice chromosome 1 flanked by RM11943 and RM431 in all three populations. In combined analysis over two years, <it>qDTY</it>_{<it>1.1 </it>}showed an additive effect of 29.3%, 24.3%, and 16.1% of mean yield in N22/Swarna, N22/IR64, and N22/MTU1010, respectively, under RS. <it>qDTY</it>_{<it>1.1 </it>}also showed a positive effect on GY in non-stress (NS) situations in N22/Swarna, N22/IR64 over both years, and N22/MTU1010 in DS2009.</p> <p>Conclusions</p> <p>This is the first reported QTL in rice with a major and consistent effect in multiple elite genetic backgrounds under both RS and NS situations. Consistency of the QTL effect across different genetic backgrounds makes it a suitable candidate for use in marker-assisted breeding.</p