Obsessive-Compulsive Disorder in Primary Care: Overview on Diagnosis and Management

Background: Obsessive-Compulsive Disorder (OCD) is a debilitating condition marked by the presence of intrusive obsessions and repetitive compulsions. The primary care setting often serves as the first line of contact for individuals grappling with mental health issues, making it a crucial frontier in the early detection and management of OCD. Therefore, the accurate diagnosis of OCD in such settings is essential for effective management. Objective: This review article aims to provide a comprehensive overview of the diagnostic process for OCD, emphasizing the clinical presentation, differential diagnosis, and various diagnostic tools available. Additionally, it explores current strategies for managing OCD, including pharmacological and psychotherapeutic interventions. Methodology: For this review, a comprehensive literature search was conducted using Google Scholar and PubMed databases. Keywords such as "Diagnosis," "obsessive compulsive disorder," and "management" were employed to narrow down relevant studies. Both qualitative and quantitative research papers were included, while non-English publications and those lacking peer-review were excluded. Results: Core symptoms of OCD include obsessions and compulsions, with the Y-BOCS being a standard measure for diagnosis. Differential diagnosis is essential to distinguish OCD from other conditions. SSRIs have been recognized as first-line pharmacological treatments. CBT, particularly Exposure and Response Prevention, remains a potent psychotherapeutic intervention. Emerging treatments like DBS and TMS offer hope for those unresponsive to conventional treatments. Combination therapies have shown enhanced efficacy in certain cases. Conclusion: The meticulous diagnosis of OCD requires recognizing its core symptoms, ruling out other conditions, and leveraging validated clinical tools. A multi-faceted management approach combining pharmacological and psychological treatments ensures optimal patient outcomes, with ongoing research introducing promising new interventions

The reliability and criterion validity of 2D video assessment of single leg squat and hop landing

The objective was to assess the intra-tester, within and between day reliability of measurement of hip adduction (HADD) and frontal plane projection angles (FPPA) during single leg squat (SLS) and single leg landing (SLL) using 2D video and the validity of these measurements against those found during 3D motion capture. 15 healthy subjects had their SLS and SLL assessed using 3D motion capture and video analysis. Inter-tester reliability for both SLS and SLL when measuring FPPA and HADD show excellent correlations (ICC2,1 0.97–0.99). Within and between day assessment of SLS and SLL showed good to excellent correlations for both variables (ICC3,1 0.72–91). 2D FPPA measures were found to have good correlation with knee abduction angle in 3-D (r = 0.79, p = 0.008) during SLS, and also to knee abduction moment (r = 0.65, p = 0.009). 2D HADD showed very good correlation with 3D HADD during SLS (r = 0.81, p = 0.001), and a good correlation during SLL (r = 0.62, p = 0.013). All other associations were weak (r < 0.4). This study suggests that 2D video kinematics have a reasonable association to what is being measured with 3D motion capture

Imaging the cellular components of the immune system for advancing diagnosis and immunotherapy of cancers

Immunotherapy has gathered momentum in the advanced generation of cancer therapeutics. Many unresectable resistant tumor subtypes are ideal candidates for immunotherapy; however, the efficacy is limited because of heterogeneity of both malignant cells and non-malignant cells of the tumor microenvironment, including stromal and immune cells. The success of immunotherapy is largely dependent on the population of individual immune cell types between patients of the same tumor subtype, and the expression of biomarkers that are expressed by the components of the immune system. Hence, it is imperative to first identify the components of the immune system, visualize these populations in the tumor microenvironment, and then devise specifically targeted immunotherapies. In this review, we have outlined strategies to characterize the cellular components of the immune system with clinically relevant imaging modalities. The importance of high dimensional analyses including mass cytometry and unbiased single-cell RNA sequence analysis in visualizing the ideal candidates for immunotherapy has been discussed. This review stresses the importance of immuno-imaging as a means to further develop targeted immunotherapies for cancer

Preparation of Activated and Non-Activated Carbon from Conocarpus Pruning Waste as Low-Cost Adsorbent for Removal of Heavy Metal Ions from Aqueous Solution

Conocarpus pruning waste, an agricultural byproduct, was converted into low-cost activated and non-activated carbons and used for the remediation of Cd2+, Cu2+, and Pb2+ from aqueous solutions. The carbonization was carried out at 400 °C, while the activation was carried out in the presence of KOH and ZnCl2. Batch single-solute and multi-solute equilibrium and kinetic experiments were carried out to determine the adsorption capacities of the prepared activated and non-activated carbons, and these were further compared with commercially available activated carbon. The results showed that KOH-activated carbon (CK) outperformed the other activated and non-activated carbons in terms of adsorption efficiency. CK removed >50% of the applied Cd2+ and Cu2+ and 100% of Pb2+ at the initial concentration of 40 mg L-1. Interestingly, the performance of Conocarpus-derived non-activated carbon was better than that of the commercial activated carbon, as observed from the Langmuir maximum adsorption capacities of 65.61, 66.12, and 223.05 µmol g-1 for Cd2+, Cu2+, and Pb2+, respectively. The Pb2+ was the metal most easily removed from aqueous solution because of its large ionic radius. The kinetic dynamics were well described by the pseudo-second order and Elovich models

Psychometric Properties of the Athens Insomnia Scale in Occupational Computer Users

Background: Various studies have shown that insomnia is associated with computer use. The Athens Insomnia Scale (AIS) is an 8-item tool that has been widely used for screening insomnia. No studies have investigated the psychometric validity of AIS in occupational computer users. Objective: the current research aimed to test the psychometric properties of the AIS among occupational computer users. Materials and Methods: a sample of four hundred and twenty-four occupational computer users (age: 20&ndash;65 years and body mass index: 21.6 &plusmn; 3.5 kg/m2) completed an AIS and a socio-demographic questionnaire in this cross-sectional study. Results: a confirmatory factor analysis demonstrated that the three-factor model had an adequate fit (the goodness of fit index (0.95), incremental fit index (0.90) and &chi;2/df (2.61)). Evidence was found for configural, scalar and metric invariance of the 3-factor model across gender groups. A moderate level of internal consistency was implied by a Cronbach&rsquo;s alpha of 0.66. Conclusion: the findings of the present research support the validity of AIS for screening insomnia, as demonstrated by the scale&rsquo;s psychometric properties; its internal consistency, internal homogeneity, item discrimination, and factorial validity

Feasibility, long‐term safety and immune monitoring of regulatory T cell therapy in living donor kidney transplant recipients

Short‐term outcomes in kidney transplantation are marred by progressive transplant failure and mortality secondary to immunosuppression toxicity. Immune modulation with autologous polyclonal regulatory T cell (Treg) therapy may facilitate immunosuppression reduction promoting better long‐term clinical outcomes. In a Phase I clinical trial, 12 kidney transplant recipients received 1‐10x106 Treg per kg at Day+5 post transplantation in lieu of induction immunosuppression (Treg Therapy cohort). Nineteen patients received standard immunosuppression (Reference cohort). Primary outcomes were rejection‐free and patient survival. Patient and Transplant survival was 100%; acute rejection‐free survival was 100% in the Treg Therapy vs 78.9% in the reference cohort at 48 months post‐transplant. Treg therapy revealed no excess safety concerns. Four patients in the Treg Therapy cohort had mycophenolate mofetil withdrawn successfully and remain on tacrolimus monotherapy. Treg infusion resulted in a long‐lasting dose‐dependent increase in peripheral blood Tregs together with an increase in marginal zone B cell numbers. We identified a pre‐transplantation immune phenotype suggesting a high risk of unsuccessful ex‐vivo Treg expansion. Autologous Treg therapy is feasible, safe and is potentially associated with a lower rejection rate than standard immunosuppression. Treg therapy may provide an exciting opportunity to minimize immunosuppression therapy and improve long‐term outcomes