Attitude to Medication and Insight in Patients with Schizophrenia.

INTRODUCTION : Schizophrenia, with an approximate lifetime risk of 1 in 100, and an annual incidence of 0.5 to 5.0 per 10,000, is one of the leading causes of disability in the world. As per the assessment of leading cause of years lived with disability, worldwide statistics showed that schizophrenia ranks ninth in the order among various other disorders that causes disability to an individual. OBJECTIVES : 1. To assess the level of insight and attitude towards medication in patients with chronic Schizophrenia. 2. To determine factors associated with insight and attitude to medication in patients with chronic schizophrenia. 3. To determine the relationship between insight and attitude to medication in this group of patients with chronic schizophrenia. METHODS: A cross-sectional survey of insight into the illness and attitude towards medication of consenting patients suffering from chronic schizophrenia using the schedule for assessment of insight (SAIE) and drug attitude inventory (DAI). Clinical assessment of psychopathology using PANSS and assessment of treatment adherence using subjective (Morisky Scale) and objective (chart review) were done to supplement assessment of relation between severity of illness, insight, attitude towards medications and compliance to medications in consecutively recruited outpatients. Data was analyzed using chi square statistics for significant association with a corresponding p value of less than 0.05 suggesting statistically significant association between the variables. RESULTS: All the 101 patients suffering from chronic schizophrenia were found to be mild to moderately ill in terms of psychopathology and had good to moderate insight into their illness. Those who had good insight into their illness expectedly had a favorable attitude towards medications. The degree of psychopathology was inversely correlated with insight into the illness and compliance to medications. Compliance to medications is a larger complex construct which seems to be affected by the severity of illness; however neither good insight into the illness nor a favorable attitude towards medications seems to significantly alter the rates of compliance to treatment. CONCLUSIONS : In this study population of patients with schizophrenia who regularly attend the outpatient department, the majority were females, aged less than 35, married, unemployed, belonging to the low socio economic class, residing in the rural areas, Hindu by religion, having a continuous course of disorder with mild severity, manifesting good insight, noncompliant with medication as per the Morisky scale and compliant as per the chart review and with no physical comorbidity or substance use or family history of any psychiatric morbidity. There was significant negative correlation between the total insight score as per SAI E and the total PANSS ( p value 0.007). Majority of patients (95 %) of this study population had a favourable attitude to medication. PANSS severity and Drug attitude inventory (DAI 10) showed a negative association (p value =0.001) in that the more the psychopathology the less favourable was the attitude towards medication. According to the Morisky scale, the patients were less compliant regardless of the psychopathology as assessed by PANSS (0.046). As per the chart review however it was seen that patients with mild psychopathology were more compliant compared to those patients with moderate psychopathology. (p=0.047). PANSS score was associated with insight, attitude to medication and compliance as assessed by the different tools. However insight was not related to compliance or attitude to medication

Magnetic properties of polypyrrole - coated iron oxide nanoparticles

Iron oxide nanoparticles were prepared by sol -gel process. Insitu polymerization of pyrrole monomer in the presence of oxygen in iron oxide ethanol suspension resulted in a iron oxide - polypyrrole nanocomposite. The structure and magnetic properties were investigated for varying pyrrole concentrations. The presence of the gamma - iron oxide phase and polypyrrole were confirmed by XRD and FTIR respectively. Agglomeration was found to be comparatively much reduced for the coated samples, as shown by TEM. AC susceptibility measurements confirmed the superparamagnetic behaviour. Numerical simulations performed for an interacting model system are performed to estimate the anisotropy and compare favourably with experimental results.Comment: 11 pages,8 figure

Incidence of respiratory infections and its correlation with smoke exposure among infants from an urban field practice area in Tamil Nadu

Background: Children’s acute lower respiratory infections are most prevalent among new-born. Clinical evaluation and symptoms help to establish the connection between smoke exposure and acute respiratory tract infection (ARTI). Furthermore, there is proof that exposing children to coal smoke considerably increases their risk of developing ARTI. Aims and Objectives: This study was designed to estimate the incidence of respiratory tract infection (RTI) among selected cohort of infants in urban field practice area of Tamil Nadu and to correlate the incidence of RTIs with smoke practices. Materials and Methods: In Tamil Nadu’s urban field practice area, a cohort study of infants was done. A house-to-house survey was conducted and information was gathered among 150 newborns who were tracked after being selected as a period sample based on inclusion criteria at a 15* visit. Numerous data on ARI episodes, housing circumstances, and smoke exposure were gathered and correlated. Software such as Epi info and SPSS version 22 were used to analye data. Results: The incidence of TI was calculated to be 1.7 episodes per 100 person days and 4.7 on average among the 150 newborns chosen. Nearly 48% of people lived in huts, 84% had indoor kitchens, and 75% cooked with gas. Infants who appeared to regularly be exposed to passive smoking have a little increase in the incidence of mean RTI bouts. Conclusion: The additional hospital admissions, which are entirely preventable, place a heavy load on the public health system. It is evident that new initiatives are required to stop infants from being exposed to passive smoke during and after pregnancy. Improving international Electrotechnical commission activities play an active role is reducing incidence of RTIs among infants. Intensified educational interventions on ill effects of indoor and outdoor smoke, passive smoking helps in addressing the issue

Dopamine Regulates Angiogenesis in Normal Dermal Wound Tissues

Cutaneous wound healing is a normal physiological process and comprises different phases. Among these phases, angiogenesis or new blood vessel formation in wound tissue plays an important role. Skin is richly supplied by sympathetic nerves and evidences indicate the significant role of the sympathetic nervous system in cutaneous wound healing. Dopamine (DA) is an important catecholamine neurotransmitter released by the sympathetic nerve endings and recent studies have demonstrated the potent anti-angiogenic action of DA, which is mediated through its D2 DA receptors. We therefore postulate that this endogenous catecholamine neurotransmitter may have a role in the neovascularization of dermal wound tissues and subsequently in the process of wound healing. In the present study, the therapeutic efficacy of D2 DA receptor antagonist has been investigated for faster wound healing in a murine model of full thickness dermal wound. Our results indicate that treatment with specific D2 DA receptor antagonist significantly expedites the process of full thickness normal dermal wound healing in mice by inducing angiogenesis in wound tissues. The underlined mechanisms have been attributed to the up-regulation of homeobox transcription factor HoxD3 and its target α5β1 integrin, which play a pivotal role in wound angiogenesis. Since D2 DA receptor antagonists are already in clinical use for other disorders, these results have significant translational value from the bench to the bedside for efficient wound management along with other conventional treatment modalities

Clozapine re-challenge under the cover of Filgrastim

Rechallenge with clozapine, despite a history of clozapine-induced neutropenia is considered in patients with a good response to the drug in the past, for whom no other treatments are effective, and in cases where the risks of withholding treatment are greater than the risks of rechallenge. Dyscrasias that occur during rechallenge are reportedly earlier in onset and longer lasting. Strategies advocated during rechallenge include frequent monitoring of white blood counts, the use of lithium or Granulocyte-Colony Stimulating Factors. We report a case of a patient with treatment-resistant schizophrenia who developed neutropenia with clozapine as a result of which the drug was discontinued. However poor response to other first and second-generation antipsychotic medication and the persisting risk of harm to himself and others necessitated the reconsideration of clozapine. The patient was re-challenged with clozapine under the cover of Filgrastim, a Granulocyte-Colony Stimulating Factor

Role of defects in transport through a quantum dot single electron transistor

The effect of a single dotlike defect on the transport through a quantum dot single electron transistor weakly coupled to external leads is studied. It is found that the conductance profile is changed significantly by the quantum mechanical tunneling between the dot and the defect and the interactions between them, both of which are dependent on the distance between the dot and the defect, as also by the morphology of the defect. In particular, we find that even a very small strength of interdot interaction has a major influence on the transport and must be taken into account in device fabrication

Believing and acting on fake news related to natural food:the influential role of brand trust and system trust

Abstract Purpose: Fake news represents a real risk for brands, particularly for firms selling essential products, such as food items. Despite this anecdotal acknowledgement, the dynamics of the relationship between fake news and brand reputation remain under-explored. The present study addresses this gap by examining the association of consumer values (universalism and openness to change), brand trust, fake news risk and system trust in the context of natural food products. Design/methodology/approach: The study utilised a cross-sectional survey design and the mall-intercept method to collect data from 498 consumers of natural food residing in India. To test the hypotheses, which were grounded in the stimulus-organism-response (SOR) framework, the collected data were analysed using covariance-based structural equation modelling in SPSS AMOS. The conceptual model proposed universalism and openness to change as stimuli, brand trust as an internal state or organism and fake news risk — captured through the tendency of consumers to believe and act on fake news — as a response. Findings: The findings support a positive association of universalism with brand trust and a negative association with fake news risk. In comparison, openness to change has no association with either brand trust or fake news risk. Brand trust, meanwhile, is negatively related to fake news, and this association is moderated by system trust. Furthermore, brand trust partially mediates the relationship between universalism value and fake news risk. Originality/value: Notably, the present study is one of the first attempts to understand the fake news risk associated with natural food brands by utilising the SOR framework in an emerging market setting. The study provides interesting insights for policymakers, brands and consumers