A study of psychiatric co-morbidity among alcohol dependents

Background: The alcohol use disorders are frequently associated with other co-morbid psychiatric disorders. The aim of this study was to describe the demographic variables, drinking history and psychiatric co-morbidity in alcohol dependent subjects.Methods: In this study, 40 consecutive patients were enrolled. After a minimum 1 month of sobriety, patients who fulfilled ICD-10 criteria of alcohol dependence were interviewed for data collection using Alcohol Use Disorders Identification Test (AUDIT), MINI-International Neuropsychiatric Interview (MINI) (Version-6.0) and a specially designed sociodemographic and clinical interview proforma. Subjects with substance use except tobacco were excluded from study. Main group comparison used chi-square test for categorical variables and the t-test for continuous variables.Results: Most of the patients studied were >40 years of age. Majority were employed (92%), lived in nuclear families (78%) and came from rural background (77.5%). Forty five percent of the patients initiated alcohol drinking between 16-25 years and reported peer pressure (50%) as most significant factor responsible for initiation of drinking alcohol. Mean age of developing alcohol dependence was 25.12 years (SD=4.28). Mean AUDIT score for subjects was 27.7 (SD=4.73). Lifetime psychiatric co-morbid disorders were detected in 45%. Psychiatric disorders most frequently associated with alcohol dependence were major depressive disorder (10%), bipolar affective disorder (7.5%), dysthymia (5%), anxiety disorders (7.5%) and antisocial personality disorder (5%).Conclusion: The study indicates that psychiatric disorders are prevalent in alcohol dependents and mood disorders are the most prevalent ones. It was also observed that co-morbid psychiatric disorders are associated with more severe alcohol problems

Burn out and depression in paramedical workers of tertiary care hospital during COVID-19 pandemic

Background: Medical/paramedical professionals are prone to various behavioral disorders due to work pressure. The aim of the study was to evaluate burnout and depression in paramedical workers of a tertiary care hospital during COVID-19.Methods: Paramedical health care workers were assessed using online questionnaire containing self-administered questionnaire in this cross-sectional study between March 2021 and May 2021. Burnout self-test, depression, and anxiety were measured.Results: In this study, only 2.6% had at very severe risk of burnout and 7.8% were at severe risk of burnout while 3.9% had no signs of burnout. Approximately 80% of the patients had no depression. While there were 19.5% had mild to severe depression. Only eight out of 77 subjects had clinically significant symptoms of anxiety. Two subjects were having comorbid illness.Conclusions: A considerable percentage of HCWs experience burnout, depression, and anxiety

Undergraduate nursing students’ attitude towards mental illness: a cross sectional study

Background: People suffering from mental illness commonly face stigma, bias, and discrimination by general public. Health care professionals are not immune to social biases and share the public's attitude meted out to people with mental illness. Nursing students are future health manpower. There are only few studies conducted on medical students’ attitude towards people with mental illnesses in India. We have planned this study to examine the undergraduate nursing students’ attitude towards people suffering from mental illnesses.Methods: It was a cross-sectional study. A total of 220 undergraduate nursing students were selected randomly with their consent to complete the Attitude Scale for Mental Illness (ASMI).Results: The nursing students were found to have a significant positive attitude towards mental illness in five of the six attitudes factors: Restrictiveness (8.42), benevolence (28.6) and stigmatization (7.3), separatism (15.6) and stereotype (9.4) However, these students had negative attitude in pessimistic predictions (12.5) domain as they rated this domain slightly on the higher side.Conclusions: Academic education in this field must be conceptualized and planned in order to favor the change of the attitudes that includes greater utilization of those teaching strategies that challenge beliefs and assumptions and promote a commitment to provide holistic care to people with mental illness

Assessment of burn-out among staff nurses working in a tertiary care health centre in North India

Background: This descriptive, cross sectional study identified the occurrence of burnout and some associated factors among nurses working in various departments at Indira Gandhi Medical College, Shimla, Himachal Pradesh, India which is a tertiary care health centre in the state.Methods: A total of 257 nurses screened in the hospital out of which 81 completed the study. Eighty-one nurses answered a self-administered questionnaire (sociodemographic aspects, working conditions, and Maslach Burnout Inventory). Mean scores were compared using ANOVA test. Student T-test was applied to compare mean scores between the groups.Results: All the participants were females (100%), with up to five years’ experience. High levels of emotional stress (45.7%) and depersonalization (24.7%) were identified, as well as low professional fulfilment (6.2%), and 8.6% presented burnout. The following factors were associated: high levels of emotional stress and always perform tasks very quickly (p=0.04) and receiving a salary incompatible to the effort employed (p=0.03); high levels of depersonalization and with up to five years’ experience (p=0.02) and often perform tasks very quickly (p=0.008). For 19.0%, at least two of the three dimensions pointed to high propensity to the syndrome.Conclusions: Searching for personal solutions for work problems must draw our attention, since it discourages health and work performance. Professionals may feel more fulfilled and satisfied by adjusting their work expectations. However, on a long-term basis, persisting in stressful work conditions enhances emotional exhaustion, depersonalization and feelings of low fulfilment at work

Prevalence of depression and its associated factors among medical students: a study using beck depression inventory

Background: Medical education carries with it a great burden of stress that can result in depression. This study was conducted to assess the prevalence of depression in medical students and various factors contributing to depression in the institute.Methods: A stratified random sample of 280 students was evaluated using Beck Depression Inventory by investigators. Associations between depression and year of study, addiction like alcohol use, family problems, family history of depression and staying away from home were analysed by univariate analysis.Results: The overall prevalence of depression was found to be 30.0%. Among those with depression, a majority (93%) had mild and moderate degree of depression. The study depicted that 41.6% (35) of the depressed were females and 58.3% (49) were males. As per the cut-off scores, 196 students (69.9%) scored as normal (0-9), 60 (21.4%) as mild (10-18), 18 (6.4%) as moderate (19-29), 4 (1.4%) as severe (30-40) and 2 (0.7%) as very severe (>40) depression. The prevalence of depression was comparatively less among 1st and 2nd year medical students (17.1%) and the difference between the grade of depression and year of study was found to be not significant (χ2=148, P=0.13). The prevalence was found more among those with family problems and family history of depression.Conclusions: In our study, depression was quite prevalent among medical students of the region. Our findings stressed the importance of broad screening and psychiatric counselling of this vulnerable population more meticulously

A Comparative Study of Serum Ast/Sgot Levels Among the Patients of Thyroid Disorders

Abstract: Background: Thyroid dysfunction is one of the most common endocrinological disorders. Consequentl

Techno-Economic Feasibility Analysis of Grid-Connected Microgrid Design by Using a Modified Multi-Strategy Fusion Artificial Bee Colony Algorithm

The present work investigates the techno-economic solution that can address the problem of rural electrification. To maintain a continuous power supply to this village area, a grid-connected microgrid system was designed that consists of solar photovoltaic (SPV) and battery energy storage systems (BESS). The recently introduced multi-strategy fusion artificial bee colony (MFABC) algorithm was hybridized with the simulated annealing approach and is referred to as the MFABC+ algorithm. This was employed to determine the optimal sizing of different components comprising the integrated system as well as to maximize the techno-economic objectives. For validation, the simulation results obtained by the MFABC+ algorithm are compared with the results obtained using HOMER software, the particle swarm optimization algorithms and the original MFABC algorithm. It was revealed that the MFABC+ algorithm has a better convergence rate and the potential ability to provide compromising results in comparison to these existing optimization tools. It was also discovered through the comprehensive evaluation that the proposed system has the potential capability to meet the electricity demand of the village for 24 × 7 at the lowest levelized cost of electricity

Reliability and Network Performance Enhancement by Reconfiguring Underground Distribution Systems

Contemporary distributions are now going to underground their overhead distribution lines due to techno-social reasons. Reliability and loss reduction are the two prime objectives for distribution system operation. Since failure rates of ungrounded cables are the function of Joules heating besides their physical lengths, the reliability evaluation of undergrounded distribution systems needs to be reviewed. This paper suggested a suitable modification in existing reliability indices in order to make them more appropriate for underground distribution systems. A multi-objective network reconfiguration problem is formulated to enhance the reliability and performance of distribution systems while duly addressing the variability and uncertainty in load demand and power generation from renewables. The application results on a standard test bench shift the paradigm of the well-known conflicting nature of reliability and network performance indices defined for overhead distribution systems

Prevalence of vitamin D deficiency and its relationship with thyroid autoimmunity in Asian Indians: a community-based survey

25-Hydroxy vitamin D (25(OH)D) deficiency is linked with predisposition to autoimmune type 1 diabetes and multiple sclerosis. Our objective was to assess the relationship between serum 25(OH)D levels and thyroid autoimmunity. Subjects included students, teachers and staff aged 16-60 years (total 642, 244 males, 398 females). Serum free thyroxine, thyroid-stimulating hormone (TSH), and thyroid peroxidase autoantibodies (TPOAb), intact parathyroid hormone and 25(OH)D were measured by electrochemiluminescence and RIA, respectively. Thyroid dysfunction was defined if (1) serum TSH ≥ 5 μ U/ml and TPOAb>34 IU/ml or (2) TSH ≥ 10 μ U/ml but normal TPOAb. The mean serum 25(OH)D of the study subjects was 17.5 (SD 10.2) nmol/l with 87 % having values ≤ 25 nmol/l. TPOAb positivity was observed in 21 % of subjects. The relationship between 25(OH)D and TPOAb was assessed with and without controlling for age and showed significant inverse correlation (r - 0.08, P = 0.04) when adjusted for age. The prevalence of TPOAb and thyroid dysfunction were comparable between subjects stratified according to serum 25(OH)D into two groups either at cut-off of ≤ 25 or >25 nmol/l or first and second tertiles. Serum 25(OH)D values show only weak inverse correlation with TPOAb titres. The presence of such weak association and narrow range of serum 25(OH)D did not allow us to interpret the present results in terms of quantitative cut-off values of serum 25(OH)D. Further studies in vitamin D-sufficient populations with wider range of serum 25(OH)D levels are required to substantiate the findings of the current study

Frequency of peripheral neuropathy in pre diabetics in sub Himalayan region: a cross sectional observational study

Background: Peripheral neuropathy in pre diabetics has been studied in various studies till now. Many are in support and many against. No data was available in any study using all three criteria i.e. impaired fasting glucose, impaired glucose tolerance and HbA1C. Aim was to study the frequency of peripheral neuropathy in pre diabetics in a tertiary health care centre in sub Himalayan region.Methods: A 50 patients of prediabetes were enrolled for this study; preformed proforma was used to collect the information, data on examination and investigations. Then these patients were subjected to nerve conduction studies.Results: Out of total 50 pre diabetic patients 9(18%) were diagnosed having peripheral neuropathy. Maximum number of pre diabetic patients were (26) in the age group 46-55 years with mean age of 44.49 years ±7.01 (S.D.). 28 (56%) were males with a female to male ratio of 1:1.27. 20% patients had complaint of polyuria, 12% presented with polydipsia, 14% of total pre diabetic patients had paresthesia on history. 6% patients had impaired vibration and position sense on clinical examination. Out of total 9 patients having evidence of Peripheral Neuropathy 6 (66.66%) were meeting all three criteria for Prediabetes while 8 (88.88%) had IFG, 7 patients had IGT. 42% of the patients were fulfilling the criteria of metabolic syndrome. 28 had raised TGs and out of them 5 (17.8%) had peripheral neuropathy. Out of 24 obese patients, 4 (16.6%) had peripheral neuropathy. Out of 9 patients with peripheral neuropathy 66.66% patients were considered to be suffering with peripheral neuropathy on the basis of sensory symptoms and 33.33% were considered on the basis of impaired vibration and position sense on examination, one patient diagnosed on the basis of nerve conduction studies. 38% were in high risk group of developing T2DM in future as per Indian diabetes risk score. Mean compound motor action potential (CMAP) and nerve conduction velocity (NCV) were less in patients with peripheral neuropathy in comparison to patients without peripheral neuropathy.Conclusions: Peripheral neuropathy can occur in prediabetes though it is difficult to confirm it. Most common is small fiber neuropathy which can be diagnosed on the basis of history and examination. But by diagnosing it early in the course of prediabetes, morbidity and mortality secondary to neuropathy can be prevented