Placental site trophoblastic tumor unprecedented by conception: a very rare presentation

Placental site trophoblastic tumour is the rare variant of gestational trophoblastic neoplasia with incidence rate of approximately 1/100,000 of all pregnancies. Histologically it is characterized by intermediate trophoblastic cells with few syntical elements. The index report depict a 20 years old unmarried female with no history of conception presenting with abnormal uterine bleeding and mildly elevated serum β-HCG level. Multi-modality treatment was given and she had fair outcome.

A cross-sectional study to find the prevalence of hyperprolactinemia in infertile euthyroid patients in a hospital

Background: Infertility whether primary or secondary, has multi-factorial causation, out of which hormonal imbalance is one of the important factors. Current study evaluates the prevalence of hyperprolactinemia in infertile euthyroid women.Methods: After Ethics Committee approval and written informed consent, all infertile euthyroid women (n=153) with age group 20-40 years attending outpatient department of general hospital, with marriage duration of at least one year and willing to participate in study were recruited. Male factor infertility, women with diagnosed hyperprolactinemia, thyroid abnormality, tubal factors, any congenital anomaly of urogenital tract or obvious organic lesion or with history of anxiety or other psychological disorders and on treatment for same were excluded. Detailed obstetrics history with relevant laboratory, radiological investigations including serum prolactin level was done.Results: Mean serum prolactin level was 13.89±10.03 ng/ml. Out of 153 participants, 13 had hyperprolactinemia which comprised 8.50% of the sample. The mean of the level of serum prolactin level in primary infertility cases was 13.18±8.485 ng/ml while that in secondary infertility was 17.21±15.1 ng/ml. Primary infertility was approximately half (53.85%) in hyperprolactinemia group and majority (85%) in normoprolactinemia group. Duration of married life, infertility and fasting blood sugar were positively correlated with prolactin levels.Conclusions: Prevalence of hyperprolactinemia was 8.50% with higher serum prolactin level in secondary infertility as compared to primary infertility. So, estimation of serum prolactin levels in infertile patients with euthyroid status can help to a large extent in finding the cause of infertility and may help in further management

Challenges and opportunities in mixed method data collection on mental health issues of health care workers during COVID-19 pandemic in India

Background: The present paper describes the key challenges and opportunities of mixed method telephonic data collection for mental health research using field notes and the experiences of the investigators in a multicenter study in ten sites of India. The study was conducted in public and private hospitals to understand the mental health status, social stigma and coping strategies of different healthcare personnel during the COVID-19 pandemic in India.Methods: Qualitative and quantitative interviews were conducted telephonically. The experiences of data collection were noted as a field notes/diary by the data collectors and principal investigators.Results: The interviewers reported challenges such as network issues, lack of transfer of visual cues and sensitive content of data. Although the telephonic interviews present various challenges in mixed method data collection, it can be used as an alternative to face-to-face data collection using available technology.Conclusions: It is important that the investigators are well trained keeping these challenges in mind so that their capacity is built to deal with these challenges and good quality data is obtained

Factors associated with stigma and manifestations experienced by Indian health care workers involved in COVID-19 management in India: A qualitative study

Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers

Stability Analysis in Six-row Barley Genotypes for Grain Yield in Multi-environmental Trails Using Eberhart and Russel (1966)

The current study aimed to determine the phenotypic stability for grain yield per plant under three distinct environmental conditions using fifteen parental lines and three testers with 45 crosses (30 single crosses and 15 three-way crosses) of six-row barley in three replications using Randomized Block Design. Eberhart and Russell (1966) developed the modal to examine stability. The mean sum of squares due to genotype and environment wassquares due to genotype and environment were found to be significant for grain yield per plant, which showed the differential effect of environment on genotypes. For grain yield per plant, it was also observed that the mean sum square resulting from the climate + (G x E) interaction, E (linear), and G x E (linear) was significant. With a non-significant deviation from regression (S2di=0) and regression coefficient near unity (bi=1), the genotypes BG 959, BG 105 x RD 2508, PL 751 x RD 2508, DWRB 137 x RD 3005, and RD 2035 x F1 exhibited higher grain yield than the population mean. These genotypes were the most stable and desirable under variable environmental conditions. These genotypes could be used as donors in regular breeding programs to improve barley grain yield

Genetic Divergence Study in Groundnut Genotypes (Arachishypogaea L.)

Employing the Mahalanobis D2 statistic, a divergence study was performed on 36 groundnut genotypes and 13 clusters were identified. Indicating that the genotypes of these groups may be more divergent from one another, the maximum inter-cluster distance (D) was found between cluster II and cluster XIII (315.56), followed by cluster III and cluster IX (289.56), cluster III and cluster XII (289.21), and cluster XII and cluster XIII (297.11). The genotypes in the mentioned clusters showed a significant difference in the means for traits that contribute significantly to yield, indicating that the genotypes in these clusters make ideal parents in a hybridization programme to produce transgressive segregants and improve groundnut

Adverse drug reactions in psychiatry outpatient department of a tertiary care hospital in Western Uttar Pradesh: An observational study

Objective: Psychiatric disorders are chronic in nature which require medications for a long duration. These medications have been associated with many adverse events. Failure to recognize an adverse drug reaction (ADR) exposes the patient to continuing risk of ADR, leading to a significant impact on patient's quality of life. Thus, the present study carried out to identify the pattern of ADRs reported due to psychotropic medication. Methods: This was a cross-sectional study conducted to analyze ADRs reported from the psychiatry department of a tertiary care teaching hospital from October 2021 to March 2022. Findings: A total of 137 ADRs were identified from 102 patients. Majority of the ADRs were reported from antidepressants, with paroxetine being the leading offending drug. The central nervous system was most commonly affected, and dizziness (13.13%) was the most common ADR noted. On causality assessment, 97 ADRs (70.8%) were of “possible” type. Almost half of the patients with ADRs (47.5%) recovered spontaneously. No ADR encountered turned out to be fatal. Conclusion: The present study revealed that the majority of ADRs reported from psychiatry OPD were mild in nature. We reinforce the identification of ADR is crucial in the hospital setting process as it gives an insight into the risk-benefit ratio for rational use of the drug

Psychosocial impact of COVID-19 pandemic on healthcare workers in India & their perceptions on the way forward - A qualitative study

Background & objectives: The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored. Methods: A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India. Results: HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic. Interpretation & conclusions: The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families

Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India-A cross-sectional study.

BackgroundCOVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India.MethodsA cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers.ResultsOverall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66-3.41), income≥20000(AOR = 1.74, 95% CI, (1.16-2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09-2.46), contact tracing (AOR = 2.05, 95% CI (1.1-3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14-6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28-2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions).ConclusionThe study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country