Atomoxetine for attention deficit hyperactivity disorder in children and adolescents with autism: A systematic review and meta‐analysis

Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta‐analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent‐rated hyperactivity (standardized mean difference [SMD] = −0.73, 95% Confidence Interval, CI = −1.15 to −0.34) and parent‐rated inattention (SMD = −0.53, 95% CI = −0.93 to −0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non‐serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542–552. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Atomoxetine is prescribed for Attention Deficit Hyperactivity Disorder (ADHD). About a third of children and adolescents with autism also suffer from ADHD. We carried out an analysis of data reported from a specific kind of medication trials which had examined the effectiveness and side effects of atomoxetine in this patient population. We could find only three such trials and analyzed the reported data. Our analysis revealed that atomoxetine is effective in improving symptoms of ADHD like hyperactivity and inattention and also causes side effects like nausea, vomiting, decreased sleep, and decreased appetite. However, the existing data are insufficient to provide a conclusive statement with certainty and more trials are needed for this

Assessment of Knowledge About RLS Among Medical Teachers and Undergraduate Students Using Newly Developed Questionnaire: K-RLS

Purpose: This study was aimed to assess knowledge regarding RLS among medical teachers and medical students. Method: ‘Knowledge about RLS (K-RLS)’ questionnaire was developed, validated and used to assess knowledge of study participants about RLS. It was applied to 50 medical teachers likely to get patients with RLS in addition to 324 undergraduate medical students. Results: Individual item validation ranged between 0.8 and 1. Average scale CVI (S-CVI/Ave) was 0.95 for the whole questionnaire and universal agreement (S-CVI/UA) scores for whole of the questionnaire was 0.75. K-RLS had good internal consistency (Cronbach’s alpha = 0.89). Results showed that knowledge regarding RLS was poor among students as well as medical teachers. Conclusion: K-RLS is a reliable tool to assess knowledge about RLS among health care professionals. Knowledge about RLS is poor among medical students as well as teachers

Family burden in injecting versus noninjecting opioid users

Background: A substance-dependent person in the family affects almost all aspects of family life that also impact the lives of the significant others and causes enormous burden. Objectives: This study was aimed to assess the pattern of burden borne by the family caregivers of patients with opioid-dependence-injecting drug users (IDU) and noninjecting drug users (NIDU). Materials and Methods: A cross-sectional study was conducted with ICD-10 diagnosed-opioid-dependent subjects (IDU and NIDU, N = 40 in each group) and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in North India. Family Burden interview schedule was used to assess the pattern of burden borne by the family caregivers. Results: The IDU group was characterized by older age, longer duration of substance dependence, greater subjective and objective family burden in all the areas compared to NIDU group, and single status and unemployment were associated with severe objective burden. The family burden was associated neither with age, education, or duration of dependence of the patients, nor with family size, type of caregiver or caregiver′s education in either group. Conclusion: All caregivers reported a moderate or severe burden, which indicates the significance and need for further work in this area

Knowledge about obstructive sleep apnea among medical undergraduate students: A long way to go!

OBJECTIVE: The aim is to study the knowledge and attitude of medical undergraduate students regarding obstructive sleep apnea (OSA). MATERIALS AND METHODS: This cross-sectional study involved 324 medical undergraduate students in clinical semesters. Knowledge and attitude regarding adult OSA were assessed using the obstructive sleep apnea knowledge and attitude (OSAKA), and to evaluate the same about childhood OSA, OSAKA-KIDS was used. RESULTS: Results showed that the study population was not informed about OSA among adults as well as kids. Most of the participants could recognize that snoring was a common symptom of adult OSA but failed to identify the association between childhood OSA and hyperactivity. The participants had a good knowledge about the pathophysiology of OSA. More than 80% of students reported that OSA is an important disorder and that these patients should be identified. CONCLUSION: Medical undergraduates are poorly informed about OSA

Family burden in injecting versus noninjecting opioid users

Background: A substance-dependent person in the family affects almost all aspects of family life that also impact the lives of the significant others and causes enormous burden. Objectives: This study was aimed to assess the pattern of burden borne by the family caregivers of patients with opioid-dependence-injecting drug users (IDU) and noninjecting drug users (NIDU). Materials and Methods: A cross-sectional study was conducted with ICD-10 diagnosed-opioid-dependent subjects (IDU and NIDU, N = 40 in each group) and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in North India. Family Burden interview schedule was used to assess the pattern of burden borne by the family caregivers. Results: The IDU group was characterized by older age, longer duration of substance dependence, greater subjective and objective family burden in all the areas compared to NIDU group, and single status and unemployment were associated with severe objective burden. The family burden was associated neither with age, education, or duration of dependence of the patients, nor with family size, type of caregiver or caregiver′s education in either group. Conclusion: All caregivers reported a moderate or severe burden, which indicates the significance and need for further work in this area