Depression and anxiety disorders among schoolgoing adolescents in an urban area of South India

Context: Adolescence is a period of turmoil, leading to several mental health challenges including anxiety and/or depression. Aims: To study the prevalence of depression and anxiety among higher school going adolescents and their sociodemographic correlates. Settings and Design: This cross-sectional study included 201 schoolgoing adolescents. Subjects and Methods: Depression and anxiety were measured using Beck Depression Inventory and Screen for Child Anxiety Related Disorders. Statistical Analysis Used: Chi-square test and binary logistic Regression with Hosmer–Lemeshow goodness-of-fit model. Results: Overall, 82 (40.8%) showed depression (from mild mood disturbance to severe and extreme depression). Among females, it was 49.3% (vs. 35.9% among males, odds ratio [OR] 2.00; 95% confidence interval [CI]: 1.02–03.97, P = 0.046). Overall, 110 (54.7%) participants had one or the other type of anxiety. Depression among the participants having one or other type of anxiety was 60% (vs. 17.6% without anxiety, OR 7.34; 95% CI: 3.68–14.64, P < 0.0001). Conclusions: Depression and anxiety were high among the study participants. Co-existing anxiety and female gender are significantly associated with depression among them. Increasing age, socioeconomic factors, and parental education are other factors influencing depression and anxiety but were statistically not significant

Comparative Evaluation of Efficacy of Chlorhexidine and Herbal Mouthwash as a Preprocedural Rinse in Reducing Dental Aerosols: A Microbiological Study

Objective. The risk to dentists, assistants, and patients of infectious diseases through aerosols has long been recognized. The aim of this study was to evaluate and compare the efficacy of commercially available preprocedural mouth rinses containing 0.2% chlorhexidine (CHX) gluconate, Befresh™ herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. Materials & Methods. This was a single-center, double-masked, placebo-controlled, randomized, three-group parallel design study. 30 patients (10 patients in each group) were recruited in the study. Patient rinsed mouth with 10 ml of CHX, 10 ml Befresh™, or 10 ml water. All the patients underwent supragingival ultrasonic scaling for a minimum of 30 min. The aerosol collection was done using a blood agar plate. The blood agar plates were kept approximately 12 inches from the patient’s mouth. The microbial culture was analyzed. The colony-forming unit (CFU) counting in all three groups was assessed using one-way ANOVA test to compare among the groups (p value <0.001). The intergroup comparison was done using the post hoc Tukey test. Result. There was a marked reduction in the CFU in the CHX group in all three areas. This was followed by Befresh™ (Sagar Pharmaceuticals) mouthwash. There was no reduction in the CFU of the water group. Conclusion. This study proves that a regular preprocedural mouth rinse could significantly reduce the majority bacteria present in aerosols generated by the use of an ultrasonic unit, and Befresh™ mouth rinse was found to be equally effective in reducing the aerosol contamination to 0.2% CHX gluconate

Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis.

ObjectivesWe conducted a meta-synthesis of qualitative studies to synthesize the views of psychiatric patients on second-generation antipsychotics (SGAs) and the healthcare providers about the metabolic monitoring of adult-prescribed SGAs.MethodsA systematic search was conducted in four databases through SCOPUS, PubMed, EMBASE, and CINAHL to identify qualitative studies of patients' and healthcare professionals' perspectives on the metabolic monitoring of SGAs. Initially, titles and abstracts were screened to exclude articles that were not relevant followed by full-text reading. Study quality was assessed by using Critical Appraisal Skills Program (CASP) criteria. Themes were synthesized and presented as per the Interpretive data synthesis process (Evans D, 2002).ResultsA total of 15 studies met the inclusion criteria and were analyzed in meta-synthesis. Four themes were identified: 1. Barriers to metabolic monitoring; 2. Patient related concerns to metabolic monitoring; 3. Support system by mental health services to promote metabolic monitoring; and 4. Integrating physical health with mental health services. From the participants' perspectives, barriers to metabolic monitoring were accessibility of services, lack of education and awareness, time/resource constraints, financial hardship, lack of interest on metabolic monitoring, patient capacity and motivation to maintain physical health and role confusion and impact on communication. Education and training on monitoring practices as well as integrated mental health services for metabolic monitoring to promote quality and safe use of SGAs are the most likely approaches to promote adherence to best practices and minimize treatment-related metabolic syndrome in this highly vulnerable cohort.ConclusionThis meta-synthesis highlights key barriers from the perspectives of patients and healthcare professionals regarding the metabolic monitoring of SGAs. These barriers and suggested remedial strategies are important to pilot in the clinical setting and to assess the impact of the implementation of such strategies as a component of pharmacovigilance to promote the quality use of SGAs as well as to prevent and/or manage SGAs-induced metabolic syndrome in severe and complex mental health disorders

Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis

Objectives We conducted a meta-synthesis of qualitative studies to synthesize the views of psychiatric patients on second-generation antipsychotics (SGAs) and the healthcare providers about the metabolic monitoring of adult-prescribed SGAs. Methods A systematic search was conducted in four databases through SCOPUS, PubMed, EMBASE, and CINAHL to identify qualitative studies of patients’ and healthcare professionals’ perspectives on the metabolic monitoring of SGAs. Initially, titles and abstracts were screened to exclude articles that were not relevant followed by full-text reading. Study quality was assessed by using Critical Appraisal Skills Program (CASP) criteria. Themes were synthesized and presented as per the Interpretive data synthesis process (Evans D, 2002). Results A total of 15 studies met the inclusion criteria and were analyzed in meta-synthesis. Four themes were identified: 1. Barriers to metabolic monitoring; 2. Patient related concerns to metabolic monitoring; 3. Support system by mental health services to promote metabolic monitoring; and 4. Integrating physical health with mental health services. From the participants’ perspectives, barriers to metabolic monitoring were accessibility of services, lack of education and awareness, time/resource constraints, financial hardship, lack of interest on metabolic monitoring, patient capacity and motivation to maintain physical health and role confusion and impact on communication. Education and training on monitoring practices as well as integrated mental health services for metabolic monitoring to promote quality and safe use of SGAs are the most likely approaches to promote adherence to best practices and minimize treatment-related metabolic syndrome in this highly vulnerable cohort. Conclusion This meta-synthesis highlights key barriers from the perspectives of patients and healthcare professionals regarding the metabolic monitoring of SGAs. These barriers and suggested remedial strategies are important to pilot in the clinical setting and to assess the impact of the implementation of such strategies as a component of pharmacovigilance to promote the quality use of SGAs as well as to prevent and/or manage SGAs-induced metabolic syndrome in severe and complex mental health disorders

Glaucoma: Adverse event on use of topiramate in alcohol de-addiction

To report oral topiramate-induced glaucoma and to asses its severity and preventability. A 40-year-old manpresented with watering, redness, pain, and diminution of vision of both eyes, one week after initiation of oral topiramate 100 mg/day for alcohol de-addiction. On examination, both eyes showed conjunctival chemosis, corneal edema, shallow anterior chamber, and intraocular pressure 48 and 46 mm Hg. The symptoms and clinical findings resolved completely upon discontinuation of topiramate and administration of antiglaucoma drugs. Topiramate-induced angle-closure glaucoma and other ocular side effects are reversible if the diagnosis is made early and the drug is discontinued in time. Hence, clinician awareness is an important aspect of preventability of this adverse event